Individual provider Active NPI

Noreen Renae Sablan Dela Rosa

  • Mental Health Counselor
  • Gresham, OR
National Provider Identifier
1104533983
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CG61668972 Issued in WA
Practice address
4101 NE Division St
Gresham, OR 97030-4617
Phone
(503) 666-6575
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X CA
Mental Health Counselor 101YM0800X CG61668972 WA Primary
Peer Specialist 175T00000X

Addresses

Primary practice location

4101 NE Division St
Gresham, OR 97030-4617

Mailing address

4101 NE Division St
Gresham, OR 97030-4617
Phone (503) 666-6575

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
CG61668972WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation PastSince Nov 1, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1104533983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 NE DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304617",
            "telephone_number": "503-666-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NE DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970304617",
            "telephone_number": "503-666-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELA ROSA",
        "first_name": "NOREEN RENAE",
        "middle_name": "SABLAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG61668972",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 11, 2026; 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.