NPIMap

Organization Active NPI

Neurodivergent Peer Support LLC

  • Peer Specialist
  • Portland, OR
National Provider Identifier
1316631914
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Legal business name
NEURODIVERGENT PEER SUPPORT LLC
Practice address
1825 SE 50TH Ave Apt 107
Portland, OR 97215-3235
Phone
(619) 925-1637
NPI assigned
Jun 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Authorized official

Name
Rebecca SheelerNPI 1427773811
Title
Founder
Phone
(619) 925-1653

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

1825 SE 50TH Ave Apt 107
Portland, OR 97215-3235

Mailing address

1825 SE 50TH Ave Apt 107
Portland, OR 97215-3235
Phone (619) 925-1637

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.

NPI Registry JSON

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1316631914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 SE 50TH AVE APT 107",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153235",
            "telephone_number": "619-925-1637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 SE 50TH AVE APT 107",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972153235",
            "telephone_number": "619-925-1637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURODIVERGENT PEER SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "SHEELER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "619-925-1653"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.