MEDICARE: ELIZABETH N HART LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C102487	OR
2	101YM0800X	Mental Health Counselor	LPC.0020122	CO

General Provider Information

NPI Number	:	1275125726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH N HART LPC

Provider Business Mailing Address
First Line	:	10201 SE MAIN ST STE 10A
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97216-2968
Country	:	US
Telephone Number	:	503-255-2186
Fax Number	:

Provider Business Practice Location Address
First Line	:	10201 SE MAIN ST STE 10A
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97216-2968
Country	:	US
Telephone Number	:	503-255-2186
Fax Number	:	503-255-2194

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2021
Last Update Date	:	03/25/2026

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Directions to “ ELIZABETH N HART LPC” Practice Location

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