Jeffrey F Eldredge, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C5511 Issued in OR

Practice address

5511 SE Hawthorne Blvd
Portland, OR 97215-3367

Phone

(503) 517-1954

NPI assigned

Dec 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1013555853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 SE 113TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664903",
            "telephone_number": "503-953-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5511 SE HAWTHORNE BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153367",
            "telephone_number": "503-517-1954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDREDGE",
        "first_name": "JEFFREY",
        "middle_name": "F",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.anewdaycounseling.org",
            "affiliation": "N",
            "endpointDescription": "web address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "none",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "5511 SE Hawthorne Blvd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972153367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.anewdaycounseling.org",
            "affiliation": "N",
            "endpointDescription": "web address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5511 SE Hawthorne Blvd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972153367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sheryl Eldene, M.A.
• Charles Robert Elder, M.D.
• Jada Danae Elder
• Katherine Alicia Elder, PHD
• Jeremiah Lee Eldred, APRN
• Jennifer Eldredge
• Daniel Eldrenkamp
• Christopher Blake Eldridge
• Daniel Eldridge
• Eleanor Health Professional TX, PLLC

• Mental Health Counselor in Portland, OR
• Providers in Portland, 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 Dec 11, 2019; 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.