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SACRED PSYCHIATRY, LLC
NPI 1952996076
Clinic/Center - Mental Health (Including Community Mental Health Center) in Portland, OR

Active since March 02, 2021
1717 NE 42ND AVE STE 100E, PORTLAND, OR 97213(503) 498-6455 Get Directions Write a Review

NPPES record last updated: March 2, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Sacred Psychiatry, Llc NPPES

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

SACRED PSYCHIATRY, LLC (NPI 1952996076) is a healthcare organization registered as a mental health (including community mental health center) in Portland, Oregon and active in the NPI registry since March 2021. The organization lists Roosevelt Lewis, Owner, as its authorized official.

NPPES Registry Identity

NPI1952996076
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameSACRED PSYCHIATRY, LLC
Location Address1717 NE 42ND AVE STE 100EPortland, OR 97213-1569
Mailing Address1717 Ne 42nd Ave Ste 100ePortland, OR 97213-1569 · (503) 498-6455
Phone(503) 498-6455
Organization SubpartNo
Authorized OfficialRoosevelt LewisOwner · (503) 498-6455
Enumeration DateMarch 2, 2021
NPPES CertifiedMarch 2, 2021
✔ NPI 1952996076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
1717 NE 42ND AVE STE 100E, Portland, OR 97213
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Sacred Psychiatry, LLC's NPI number?

The NPI number for Sacred Psychiatry, LLC is 1952996076. It was assigned to this organization in the NPPES registry on March 2, 2021.

Where is Sacred Psychiatry, LLC located?

Sacred Psychiatry, LLC is located at 1717 NE 42nd Ave Ste 100E, Portland, OR 97213. The listed phone number is (503) 498-6455.

What is Sacred Psychiatry, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Sacred Psychiatry, LLC was last updated on March 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.