Sara J Young, PSS CRMII QMHA CADCI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

22-03-10374 Issued in OR

Practice address

1027 E Burnside St
Portland, OR 97214-1328

Phone

(503) 239-8444

Fax

(503) 239-8400

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Coda, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Seaside, OR
  • NPI 1750912184
  NPD

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1265084685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 WONDERLY DR",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970511632",
            "telephone_number": "971-363-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8444",
            "fax_number": "503-239-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58646 McNulty Way",
            "address_purpose": "LOCATION",
            "city": "Saint Helens",
            "state": "OR",
            "postal_code": "970516210",
            "country_code": "US",
            "telephone_number": "503-397-5211 x303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "SARA",
        "middle_name": "J",
        "credential": "PSS CRMII QMHA CADCI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-20-112",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "19-QMHA-I-02752",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000003584",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "22-03-10374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON HEALTH AUTHORITY",
            "identifier": "THW000003584",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO",
            "identifier": "22-03-10374",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO",
            "identifier": "19-QMHA-I-02752",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO",
            "identifier": "21-CRM-II-0020",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lee Young
• Rhea Young
• Robert Chenzong Young, MD
• Sandra Young
• Sandra C Young
• Sarah A Young
• Sarah Kimberly Young, M.S., NCC
• Scott A Young, M.D.
• Shannon N Young
• Shyanne Young

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.