Elijawan Addison

Individual provider Active NPI Mental Health Counselor · Saint Helens, OR

NPI 1235670936 · NPPES record last updated Mar 14, 2017

Key facts

NPI
1235670936
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
58147 Columbia River Hwy
Suite C
Saint Helens, OR 97051-6226
Phone
(503) 396-5322
Fax
(503) 410-5678
NPI assigned
Mar 14, 2017
Sex
Male
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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Medicine Wheel Recovery Services, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

58147 Columbia River Hwy
Suite C
Saint Helens, OR 97051-6226

Mailing address

58147 Columbia River Hwy
Suite C
Saint Helens, OR 97051-6226
Phone (503) 396-5322

Other providers in Saint Helens, OR

All providers in Saint Helens, OR · Mental Health Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.