Active NPI
Polk County Mental Health
- Addiction (Substance Use Disorder) Counselor
- Salem, OR
National Provider Identifier
1295857977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 04-R-19
- Legal business name
- POLK COUNTY MENTAL HEALTH
- Practice address
- 557 21St St SE
Salem, OR 97301-6526 - Phone
- (503) 991-0226
- NPI assigned
- Apr 4, 2007
- Last updated
- Aug 14, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Marie Klein, CADC-II QMHA BS
- Title
- Addictions Counselor
- Phone
- (503) 623-9289
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 04-R-19 | OR | Primary |
Addresses
Primary practice location
557 21St St SE
Salem, OR 97301-6526
Mailing address
557 21St St SE
Salem, OR 97301-6526
Phone (503) 991-0226
Other names 1
- Polk County Mental Health Addiction Services
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Addiction (Substance Use Disorder) Counselor
- Dallas, OR
- NPI 1023239761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218672000000",
"number": "1295857977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "557 21ST ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973016526",
"telephone_number": "503-991-0226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "557 21ST ST SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973016526",
"telephone_number": "503-991-0226"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POLK COUNTY MENTAL HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-04",
"last_updated": "2008-08-14",
"status": "A",
"authorized_official_last_name": "KLEIN",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "ADDICTIONS COUNSELOR",
"authorized_official_telephone_number": "503-623-9289",
"authorized_official_credential": "CADC-II QMHA BS"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "04-R-19",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Polk County Mental Health Addiction Services",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Salem, OR
- Megan Pokorny, PHARMD, RPH
- Denise Marie Polacek, LCSW
- Vanessa Isabella Polanco
- Polaris Dental Specialists
- Wendy Poling, COTA
- Polk Yamhill & Marion Child Treatment Services Inc (Poyama Counseling Services)
- Marcus L Pollard, MD
- McKayla Pollard
- Susan Polvi, LPC
- Pomeroy Eyecare, P.C. (James P. Randolph, O. D.)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.