Individual provider Active NPI

Michelle Sideroff, LMHC

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1346655917
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C5151 Issued in OR
Practice address
8383 NE Sandy Blvd Ste 205
Portland, OR 97220-4967
Phone
(503) 253-0964
NPI assigned
Jun 23, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X C5151 OR Primary

Addresses

Primary practice location

8383 NE Sandy Blvd Ste 205
Portland, OR 97220-4967

Mailing address

8383 NE Sandy Blvd Ste 205
Portland, OR 97220-4967
Phone (503) 253-0964

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250130004056 OR Practitioner - Mental Health Counselor 8426586702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Northwest Catholic Counseling CenterGroup PAC ID 0840289013, 5 clinicians

Practice addresses (Care Compare)

8383 NE Sandy Blvd
Suite 205
Portland, OR 97220-4967
Phone (503) 253-0964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C5151ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Northwest Catholic Counseling Center Mental Health CurrentSince Oct 17, 2024 Accepting new patients

Locations

8383 NE Sandy Blvd
Ste 205
Portland, OR 97220
Phone (503) 253-0964

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1346655917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8383 NE SANDY BLVD STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204967",
            "telephone_number": "503-253-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8383 NE SANDY BLVD STE 205",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204967",
            "telephone_number": "503-253-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDEROFF",
        "first_name": "MICHELLE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.