Justin Scott Nielsen, CADCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

08-08-54 Issued in OR

Practice address

3793 River Rd N
Keizer, OR 97303-4827

Phone

(503) 304-4358

Fax

(503) 304-4361

NPI assigned

Feb 4, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Renaissance Recovery Resources, Inc.

  • Community/Behavioral Health Agency
  • Keizer, OR
  • NPI 1639125156

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Oregon Recovery Behavioral Health

  • Community/Behavioral Health Agency
  • Dallas, OR
  • NPI 1164111472
  NPD (past) Authorized official
• Renaissance Recovery Resources, Inc.

  • Community/Behavioral Health Agency
  • Lake Oswego, OR
  • NPI 1124800891
  NPD (past) Authorized official
• Renaissance Recovery Resources, Inc.

  • Community/Behavioral Health Agency
  • Canby, OR
  • NPI 1902566805
  NPD (past) Authorized official

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1124324330",
    "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": "3793 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034827",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "695 SE 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Canby",
            "state": "OR",
            "postal_code": "970133848",
            "country_code": "US",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "465 Commercial St NE Ste 150",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973013414",
            "country_code": "US",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5775 Jean Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Lake Oswego",
            "state": "OR",
            "postal_code": "970355311",
            "country_code": "US",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "147 SW Court St",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "OR",
            "postal_code": "973383112",
            "country_code": "US",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "JUSTIN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "CADCII",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-04",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "08-08-54",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muoi Riley Nguyen Cole, PSYD
• Mellisa Phuong Nguyen, OD
• Pascal V Nguyen, DMD
• Phuc Minh Nguyen, OD
• Emily Nichol
• Northland Hearing Center, Inc.
• Northwest Center for Evidence-Based Psychotherapy LLC
• Northwest Counseling and Wellness LLC
• Northwest Dental Arts PC
• Northwest Sleep Therapy

• Addiction (Substance Use Disorder) Counselor in Keizer, OR
• Providers in Keizer, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.