| Blkjade. Mental Wellness, Llc. | |
|
2926 Ne Flanders St # 3a Portland OR 97232-3259 | |
| (503) 208-8258 | |
| (503) 328-7780 |
| Full Name | Blkjade. Mental Wellness, Llc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2926 Ne Flanders St # 3a, Portland, Oregon |
| Authorized Official Name and Position | Roxanne Sheena Capparelli (OWNER / SOLE MEMBER) |
| Authorized Official Contact | 5032088258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blkjade. Mental Wellness, Llc. 3519 Ne 15th Ave # 294 Portland OR 97212-2356 Ph: (503) 208-8258 | Blkjade. Mental Wellness, Llc. 2926 Ne Flanders St # 3a Portland OR 97232-3259 Ph: (503) 208-8258 |
| NPI Number | 1285418517 |
|---|---|
| Provider Enumeration Date | 08/18/2023 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285418517 | NPI | - | NPPES |
| 1861893232 | Medicaid | OR | |
| 500822543 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
Sandra M. Gonzalez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Sw Morrison St, Suite 411, Portland, OR 97205 Phone: 503-228-0939 Fax: 503-226-8069 | |
Cascadia Behavioral Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9125 Sw 55th Ave, Portland, OR 97219 Phone: 503-238-0769 Fax: 503-477-4598 | |
Edwards Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St, Suite 1100, Portland, OR 97205 Phone: 503-222-0557 | |
Wellpath Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 Se Milwaukie Ave Ste D, Portland, OR 97202 Phone: 503-784-2377 | |
Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
Cultivating A New Life Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Se Spokane St Ste 300, Portland, OR 97202 Phone: 541-904-0468 | |
Tiffany Kettermann, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2926 Ne Flanders St Ste 3c, Portland, OR 97232 Phone: 971-270-0167 |