Individual provider Active NPI

Melissa A Jones, CRM/PSS/QMHA-R

  • Addiction (Substance Use Disorder) Counselor
  • Gresham, OR
National Provider Identifier
1063177269
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
21-CRM-470 Issued in OR
Practice address
355 NW Division St
Gresham, OR 97030-5523
Phone
(503) 231-2641
Fax
(503) 231-1654
NPI assigned
Nov 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X THW000105322 OR
Mental Health Counselor 101YM0800X 25-QMHA-R-7572 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X 21-CRM-470 OR Primary

Addresses

Primary practice location

355 NW Division St
Gresham, OR 97030-5523

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502
Phone (503) 224-1044

Other identifiers 1

IdentifierTypeStateIssuer
500799872MedicaidOR

Other names 1

  • Melissa A Cedillo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21-CRM-470ORMDAddiction (Substance Use Disorder) Counselor
25-QMHA-R-7572ORMDMental Health Counselor
THW000105322ORMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1063177269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305523",
            "telephone_number": "503-231-2641",
            "fax_number": "503-231-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "CRM/PSS/QMHA-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-02",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000105322",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "25-QMHA-R-7572",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "21-CRM-470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500799872",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "CEDILLO",
            "middle_name": "A",
            "credential": "CRM/PSS/QMHA-R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.