Individual provider Active NPI

Fletcher O Marron III, MS

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1174405955
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4531 SE Belmont St Ste 205
Portland, OR 97215-1675
Phone
(920) 840-5901
NPI assigned
Jul 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4531 SE Belmont St Ste 205
Portland, OR 97215-1675

Mailing address

4531 SE Belmont St Ste 205
Portland, OR 97215-1675

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1174405955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4531 SE BELMONT ST STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972151675",
            "telephone_number": "920-840-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRON",
        "first_name": "FLETCHER",
        "middle_name": "O",
        "name_suffix": "III",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "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 Sep 16, 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.