Active NPI
Colette Deleon, LCSW
- Clinical Social Worker
- Gresham, OR
National Provider Identifier
1164566113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L3792
- Practice address
- 1700 NW Civic Dr Ste 310
Gresham, OR 97030-3774 - Phone
- (503) 666-8832
- Fax
- (503) 669-8641
- NPI assigned
- Feb 16, 2007
- Last updated
- Oct 16, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L3792 | OR | Primary |
Addresses
Primary practice location
1700 NW Civic Dr Ste 310
Gresham, OR 97030-3774
Mailing address
PO Box 8550
Pasadena, CA 91109-8602
Phone (503) 233-5405
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1700 NW Civic Dr
Suite 310
Gresham, OR 97030-3774
Phone (503) 666-8832
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L3792 | OR | MD | Clinical Social Worker |
Interoperability endpoints
- lifestancehealth.colettedeleon@148835.advancedmd-direct.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba LifeStance Health
- Clinical Psychologist
- Tacoma, WA
- NPI 1912008178
OR
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1792108800000",
"number": "1164566113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8550",
"city": "PASADENA",
"state": "CA",
"postal_code": "911098602",
"telephone_number": "503-233-5405",
"fax_number": "503-233-2696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 NW CIVIC DR STE 310",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303774",
"telephone_number": "503-666-8832",
"fax_number": "503-669-8641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELEON",
"first_name": "COLETTE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2026-10-16",
"certification_date": "2026-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L3792",
"primary": true
}
],
"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 Oct 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.