Organization Active NPI

Polk County Mental Health

  • Addiction (Substance Use Disorder) Counselor
  • Salem, OR
National Provider Identifier
1295857977
Registry record updated Aug 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
04-R-19 Issued in OR
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, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2008

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 BSNPI 1023239761
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)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 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 Other name

National Provider Directory

National Provider Directory

Practitioners & 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.

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

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.

Verify at the official NPI Registry.