| Sapphire Blue Behavioral Health Solutions | |
|
5285 Meadows Rd Ste 170 Lake Oswego OR 97035-3478 | |
| (503) 276-5216 | |
| Not Available |
| Full Name | Sapphire Blue Behavioral Health Solutions |
|---|---|
| Speciality | Counselor |
| Location | 5285 Meadows Rd Ste 170, Lake Oswego, Oregon |
| Authorized Official Name and Position | A. Nicole La Verne (CEO) |
| Authorized Official Contact | 5037265216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sapphire Blue Behavioral Health Solutions 5285 Meadows Rd Ste 170 Lake Oswego OR 97035-3478 Ph: (503) 276-5216 | Sapphire Blue Behavioral Health Solutions 5285 Meadows Rd Ste 170 Lake Oswego OR 97035-3478 Ph: (503) 276-5216 |
| NPI Number | 1558839068 |
|---|---|
| Provider Enumeration Date | 11/02/2018 |
| Last Update Date | 01/08/2024 |
| Certification Date | 01/08/2024 |
| Medicare PECOS PAC ID | 7911358775 |
|---|---|
| Medicare Enrollment ID | O20240105003842 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558839068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Monica R Meyer Pankow |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1669778940 PECOS PAC ID: 1658722681 Enrollment ID: I20240103004752 |
| Provider Name | A. Nicole La Verne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083699979 PECOS PAC ID: 3274984034 Enrollment ID: I20240207001962 |
| Provider Name | Jacquelyn T Blackwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194178830 PECOS PAC ID: 0941646889 Enrollment ID: I20240313003037 |
| Provider Name | Beth D Stoner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780154203 PECOS PAC ID: 8123466463 Enrollment ID: I20240404003097 |
| Provider Name | Shayna B Crespo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528592284 PECOS PAC ID: 1850732819 Enrollment ID: I20240508003799 |
| Provider Name | Anna M Jorge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598207508 PECOS PAC ID: 2365836665 Enrollment ID: I20240516001957 |
| Provider Name | Jeb S Oliver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578229787 PECOS PAC ID: 0547706848 Enrollment ID: I20240723002644 |
| Provider Name | Courtney H Slater |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1871847145 PECOS PAC ID: 2567908874 Enrollment ID: I20240723002953 |
| Provider Name | Vinay Gaglani |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932398583 PECOS PAC ID: 8820534142 Enrollment ID: I20240723003393 |
| Provider Name | Angela M Duncan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720327000 PECOS PAC ID: 5991245938 Enrollment ID: I20240905002161 |
| Provider Name | Ashley M Scroggins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609214717 PECOS PAC ID: 4183158488 Enrollment ID: I20241108002432 |
| Provider Name | Kristina J Higgins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811580681 PECOS PAC ID: 4880122589 Enrollment ID: I20250108003836 |
| Provider Name | Jennifer Cordova-flores |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053932731 PECOS PAC ID: 7012430606 Enrollment ID: I20250324003468 |
| Provider Name | Dianaly Galvez-hernandez |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1851868053 PECOS PAC ID: 7315462330 Enrollment ID: I20250422002534 |
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