Individual provider Active NPI

Jerry Lee Lester Swinger, CADC-R

  • Addiction (Substance Use Disorder) Counselor
  • Portland, OR
National Provider Identifier
1114768348
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
T-24-4005 Issued in OR
Practice address
211 NE 18TH Ave
Portland, OR 97232-2822
Phone
(971) 242-8544
NPI assigned
Jun 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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-24-4005 OR Primary

Addresses

Primary practice location

211 NE 18TH Ave
Portland, OR 97232-2822

Mailing address

211 NE 18TH Ave
Portland, OR 97232-2822
Phone (971) 242-8544

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-24-4005ORMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1114768348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 NE 18TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322822",
            "telephone_number": "971-242-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NE 18TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322822",
            "telephone_number": "971-242-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWINGER",
        "first_name": "JERRY",
        "middle_name": "LEE LESTER",
        "credential": "CADC-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-24-4005",
            "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 Jun 3, 2024; 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.