Individual provider Active NPI

Andrew Smittle, CADC-R

  • Addiction (Substance Use Disorder) Counselor
  • Salem, OR
National Provider Identifier
1104708999
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
T-25-5502 Issued in OR
Practice address
925 Commercial St SE Ste 250
Salem, OR 97302-4176
Phone
(503) 304-4358
Fax
(503) 304-4361
NPI assigned
Jul 22, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T-25-5502 OR Primary

Addresses

Primary practice location

925 Commercial St SE Ste 250
Salem, OR 97302-4176

Mailing address

PO Box 20674
Keizer, OR 97307-0674
Phone (503) 304-4358

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
T-25-5502ORMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Benjamin R. Wilson, MD, PC CurrentSince Jul 28, 2025 Accepting new patients

Locations

925 Commercial St SE
Ste 250
Salem, OR 97302
Phone (503) 304-4358

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": "1753142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1104708999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20674",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973070674",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 COMMERCIAL ST SE STE 250",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024176",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITTLE",
        "first_name": "ANDREW",
        "credential": "CADC-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-25-5502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.