ELISSA KATHLEEN MANTALAS MA NPI 1164605499

NPI Information

NPI: 1164605499
Provider Name: ELISSA KATHLEEN MANTALAS, MA
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
2410 SE 121ST AVE STE 216
PORTLAND, OR
ZIP 97216
Phone: (971) 570-4721
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Elissa Kathleen Mantalas, MA is a mental health counselor in Portland, OR. Elissa Kathleen Mantalas, MA NPI is 1164605499. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2410 SE 121ST AVE STE 216
PORTLAND, OR
ZIP 97216-085
Phone: (971) 570-4721

The enumeration date for this NPI number is 12/10/2007 and was last updated on 12/10/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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