Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Lupita Pena-Baltazar, QMHA

Individual provider Mental Health Counselor · NPI 1104050947

Miss. Lupita Pena-Baltazar, QMHA is a Clinical Social Worker in Woodburn, Oregon. Qualified in 2017, 9 years ago. Practices with Brightways Counseling Group LLC, a 36-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
9
Licensed in
OR
In the registry since
2009
Specialties on file
3
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Practice location Address checks out

1310 Meridian Dr
Woodburn, OR 97071-9668
Phone: (503) 953-0310
Fax: (503) 386-0439
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L10733 (OR)
Mental Health Counselor Taxonomy 101YM0800X
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1104050947
Entity typeIndividual (Type 1)
GenderFemale
Credentials QMHA
Sole proprietorNo
NPI enumeratedMay 7, 2009
Last updated in NPPESApril 17, 2025
Certification dateApril 17, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Brightways Counseling Group Llc — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Woodburn