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PACIFIC MENTAL HEALTH CLINIC LLC
NPI 1699535195
Social Worker - Clinical in Portland, OR

Active since March 21, 2024
16323 SE STARK ST STE 102, PORTLAND, OR 97233(503) 265-8922(971) 420-2990 Get Directions Write a Review

NPPES record last updated: February 24, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Pacific Mental Health Clinic Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC MENTAL HEALTH CLINIC LLC (NPI 1699535195) is a healthcare organization registered as a clinical in Portland, Oregon and active in the NPI registry since March 2024. The organization lists Kadra Abdullahi Mohamed, Owner, as its authorized official.

NPPES Registry Identity

NPI1699535195
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NamePACIFIC MENTAL HEALTH CLINIC LLC
Location Address16323 SE STARK ST STE 102Portland, OR 97233-3942
Mailing Address16323 Se Stark St Ste 102Portland, OR 97233-3942 · (503) 265-8922 · Fax (971) 420-2990
Phone(503) 265-8922
Fax(971) 420-2990
Organization SubpartNo
Authorized OfficialKadra Abdullahi MohamedOwner · (206) 489-8775
Enumeration DateMarch 21, 2024
Last NPPES UpdateFebruary 24, 2026
NPPES CertifiedFebruary 24, 2026
✔ NPI 1699535195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
16323 SE STARK ST STE 102, Portland, OR 97233
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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pacific Mental Health Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Pacific Mental Health Clinic LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Phyllis Hursey, MD
Family Practice
NPI 1427029537
1206 SE 11TH AVE
Portland, OR 97214
(503) 389-1166
✔ PECOS7.8 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Mental Health Clinic LLC's NPI number?

The NPI number for Pacific Mental Health Clinic LLC is 1699535195. It was assigned to this organization in the NPPES registry on March 21, 2024.

Where is Pacific Mental Health Clinic LLC located?

Pacific Mental Health Clinic LLC is located at 16323 SE Stark St Ste 102, Portland, OR 97233. The listed phone number is (503) 265-8922.

What is Pacific Mental Health Clinic LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Pacific Mental Health Clinic LLC enrolled in Medicare?

Yes. Pacific Mental Health Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pacific Mental Health Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Pacific Mental Health Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pacific Mental Health Clinic LLC was last updated on February 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.