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Contact Information

ST MARY'S HOME FOR BOYS
16535 SW TUALATIN VALLEY HWY
BEAVERTON, OR97006-5143
 Phone: 503-649-5651
 Fax: 503-649-7405
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counseling

103TC1900X 62 Psychologist, Clinical
 

Adolescent and Children Mental Health

261QM0855X
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Cognitive & Behavioral

103TB0200X 62 Psychologist, Clinical
 

Marriage & Family Therapist

106H00000X
 

Mental Health

101YM0800X
 

Psychiatric Hospital

283Q00000X A0[7] Hospital-Psychiatric (PPS excluded)
 

Psychologist

103T00000X 62 Psychologist, Clinical
 

Residential Treatment Facility, Emotionally Disturbed Children

322D00000X
Indicates primary specialty

NPI Profile & details for ST MARY'S HOME FOR BOYS

NPI # 1619057098
LBN Legal business name ST MARY'S HOME FOR BOYS
Authorized official MICHAEL COLE - (ASSISTANT DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 10/17/2006
Last updated 05/07/2013 - About 13 years ago
Identifiers
OR License # 17887
OR License # 891
OR License # T0433
OR Medicaid 210855
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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