Active NPI
Addam Stell, MS, LPC
- Professional Counselor
- Portland, OR
National Provider Identifier
1194095380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C3568
- Practice address
- 3415 SE Powell Blvd.
Portland, OR 97202 - Phone
- (503) 234-9591
- Fax
- (503) 722-6545
- NPI assigned
- Jan 5, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Professional Counselor | 101YP2500X | C3568 | OR | Primary |
Addresses
Primary practice location
3415 SE Powell Blvd.
Portland, OR 97202
Mailing address
3415 SE Powell Blvd.
Portland, OR 97202
Phone (503) 234-9591
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500667485 | Medicaid | OR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C3568 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429488000000",
"number": "1194095380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3415 SE POWELL BLVD.",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97202",
"telephone_number": "503-234-9591",
"fax_number": "503-722-6897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3415 SE POWELL BLVD.",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97202",
"telephone_number": "503-234-9591",
"fax_number": "503-722-6545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STELL",
"first_name": "ADDAM",
"credential": "MS, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-01-05",
"last_updated": "2015-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C3568",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500667485",
"state": "OR"
}
],
"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 Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.