Active NPI
Nicholas Valentine Dexter, MA, LPC
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1073746079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C1978
- Practice address
- 1611 NE 16TH Ave
Portland, OR 97232-1413 - Phone
- (503) 528-0150
- NPI assigned
- Aug 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C1978 | OR | Primary |
Addresses
Primary practice location
1611 NE 16TH Ave
Portland, OR 97232-1413
Mailing address
1611 NE 16TH Ave
Portland, OR 97232-1413
Phone (503) 528-0150
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1978 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251158400000",
"number": "1073746079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 NE 16TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321413",
"telephone_number": "503-528-0150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 NE 16TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972321413",
"telephone_number": "503-528-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEXTER",
"first_name": "NICHOLAS",
"middle_name": "VALENTINE",
"name_prefix": "Mr.",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-25",
"last_updated": "2009-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C1978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.