Nichole N Albelo – Mental Health Counselor

Key facts

NPI: 1164109526
Entity type: Individual (NPI type 1)
Primary specialty: Mental Health Counselor 101YM0800X
License: A14023 (OR)
Practice address: 649 NE Hood Ave
Gresham, OR 97030-7328
Phone: (971) 404-4668
Fax: (971) 273-2708
NPI assigned: Jun 28, 2023
Sex: Female
Sole proprietor: No

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.

Connected Space Counseling, LLC Professional Counselor · Gresham, OR · NPI 1194433250

NPD

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
A14023	OR	MD	Mental Health Counselor

Practice roles

Organization	Specialty	Status	New patients
Connected Space Counseling, LLC		Current since Jul 2, 2023	Accepting new patients

Locations

649 NE Hood Ave
Gresham, OR 97030
Phone (971) 404-4668

1201 SE 223rd Ave
Ste 165
Gresham, OR 97030
Phone (971) 404-4668

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Mental Health Counselor	101YM0800X	A14023	OR	Yes

Addresses

Primary practice location

649 NE Hood Ave
Gresham, OR 97030-7328

Mailing address

1201 SE 223Rd Ave Ste 165
Gresham, OR 97030-2577
Phone (971) 404-4668

Other providers in Gresham, OR

All providers in Gresham, OR · Mental Health Counselor in Oregon

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.