Sammy Travis Freshner Jr., M.ED, MAC, LPCRA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R5274 Issued in OR

Practice address

1584 NE 8TH St Ste 200
Gresham, OR 97030-5746

Phone

(503) 890-8773

NPI assigned

Aug 28, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1003691114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 NE ALTON CT",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970247736",
            "telephone_number": "503-209-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1584 NE 8TH ST STE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305746",
            "telephone_number": "503-890-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRESHNER",
        "first_name": "SAMMY",
        "middle_name": "TRAVIS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.ED, MAC, LPCRA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R5274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fred Meyer Stores Inc
• Shelby Lee Freed, FNP-C
• Beth Diane French, PSY.D.
• Fresenius Medical Care Dialysis Services - Oregon, LLC
• Fresh Perspectives Counseling
• John H Frick DMD PC, DMD
• Halley Frishkorn, RN
• Kurt David Fuerstenau, DMD
• Tristan Nadiene Fujita, ATC-R, OTC
• Full Circle Acupuncture

• Mental Health Counselor in Gresham, OR
• Providers in Gresham, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.