Modupe Desiree Bansile
Peer Specialist • Portland, OR
Professional Overview & Biography Verified Profile Summary
Modupe Bansile is a registered healthcare professional specializing in Peer Specialist in Portland, OR. Practice services are available at 209 SW FOURTH AVE, SUITE 520 under active NPI credentials.
Practice Location & Contact Primary Location
209 Sw Fourth Ave, Suite 520
Portland, OR 97204
Specialty Benchmarks & Practice Insights
Comparative analytics for Peer Specialist in Portland, OR
Practicing in Portland, OR (3408 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 175T00000X
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
NUCC Taxonomy Code: 101Y00000X
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Additional State Medicaid & Healthcare Payer Identifiers
Secondary Practice Locations
707 Ne Couch St
Portland, OR 972322922
Phone: 5035424603
445 Port Ave
Saint Helens, OR 970516225
Phone: 5415569195
209 Sw Fourth Ave, Suite 520
Portland, OR 97204
Phone: 5415569195
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Registered at 209 SW FOURTH AVE, SUITE 520, PORTLAND, OR 97204 (Tel: 5415569195)
Registered at 11073 SE MAIN ST, MILWAUKIE, OR 97222 (Tel: 5415569195)
NPI status registered as active in NPPES database
Registered at 445 PORT AVE, SAINT HELENS, OR 970516225 (Tel: 5415569195)
Registered at 445 PORT AVE, SAINT HELENS, OR 970516225 (Tel: 5415569195)
Recorded as MODUPE BANSILE
Counselor
NPI status registered as active in NPPES database
Registered at 707 NE COUCH ST, PORTLAND, OR 972322922 (Tel: 5035424603)
Registered at 7640 N CURTIS AVE, PORTLAND, OR 972176106 (Tel: 8147693193)
Recorded as MODUPE BANSILE
Counselor
First registered as active Individual Practitioner in NPPES Database.
Patient & Community Reviews
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NPI Administrative Meta
Mailing Address
11073 Se Main St
Milwaukie, OR 97222
Phone: 5415569195
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