Active NPI
Reed Carl McClintock
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1225499536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 209 SW 4TH Ave Ste 520
Portland, OR 97204-1825 - Phone
- (503) 988-5464
- Fax
- (503) 988-4386
- NPI assigned
- Mar 14, 2016
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Adult Companion | 372600000X |
Addresses
Primary practice location
209 SW 4TH Ave Ste 520
Portland, OR 97204-1825
Mailing address
209 SW 4TH Ave Ste 520
Portland, OR 97204-1825
Phone (503) 988-5464
Other practice location 1
15606 SE Division St
Portland, OR 97236-2002
Phone (971) 202-7904
Other practice location 2
8041 E Burnside St
Portland, OR 97215-1548
Phone (503) 252-3304
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coda, Inc. | Mental Health | Past | Accepting new patients |
| Coda, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Seaside, OR
- NPI 1750912184
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1225499536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 SW 4TH AVE STE 520",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972041825",
"telephone_number": "503-988-5464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 SW 4TH AVE STE 520",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972041825",
"telephone_number": "503-988-5464",
"fax_number": "503-988-4386"
}
],
"practiceLocations": [
{
"address_1": "15606 SE Division St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972362002",
"country_code": "US",
"telephone_number": "971-202-7904",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8041 E Burnside St",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972151548",
"country_code": "US",
"telephone_number": "503-252-3304",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLINTOCK",
"first_name": "REED",
"middle_name": "CARL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-14",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
}
],
"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 Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.