Shanako Devoll, CADC I, QMHA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

L7423 Issued in OR

Practice address

2450 SE Belmont St
Portland, OR 97214-2821

Phone

(503) 887-6255

Fax

(503) 212-0969

NPI assigned

Sep 2, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• S. Devoll Other name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Healing Tides Counseling, LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1578146106
  Medicare reassignment NPD Authorized official
• Wild Hearts PDX

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1265253082
  NPD Authorized official

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1316254022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093609",
            "telephone_number": "503-200-3923",
            "fax_number": "503-241-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142821",
            "telephone_number": "503-887-6255",
            "fax_number": "503-212-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVOLL",
        "first_name": "SHANAKO",
        "credential": "CADC I, QMHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-02",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "05-03-01",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L7423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "S.",
            "last_name": "DEVOLL",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Hilary Katherine Devoe, M.D.
• Jennifer E Devoe, MD
• Meg Devoe, M.D.
• Megan Devoe
• Val M Devogele, RPH
• Aubrey Page Devore
• Gregory Ellis Devore, PHD
• Heather Ann Devore
• Jacque Devore, RD, MPH, LD
• Joanne G Devore, MD

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.