OrganizationActive
Eternal Blossom Counseling LLC
NPI 1104389170 · Clinical Social Worker · Portland, OR
Provider details
- NPI number
- 1104389170
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Aiyana Lucas, Licensed Clinical Social Worker(971) 361-6747
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4531 Se Belmont St Ste 310
Portland, OR 97215-1675
Phone: (503) 810-1170
Street-level locationGet directions
Mailing address
3335 Se 69th Ave
Portland, OR 97206-2613
Registry dates
- Enumerated
- 2019-04-08
- Last updated
- 2019-04-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.