Individual provider Active NPI

Sheryl Dunn Watson, LPC, LMHC, CCMHC

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1366546913
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C1097 Issued in OR
Practice address
4800 S Macadam Ave Ste 350
Portland, OR 97239-3970
Phone
(503) 684-7948
Fax
(503) 715-1830
NPI assigned
Sep 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C1097 OR
Mental Health Counselor 101YM0800X C1097 OR Primary
Mental Health Counselor 101YM0800X LH61062285 WA
Professional Counselor 101YP2500X LH61062285 WA

Addresses

Primary practice location

4800 S Macadam Ave Ste 350
Portland, OR 97239-3970

Mailing address

4800 S Macadam Ave Ste 350
Portland, OR 97239-3970
Phone (503) 684-7948

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
I20240104000024 OR Practitioner - Mental Health Counselor 8527419555 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4800 S Macadam Ave
Suite 350
Portland, OR 97239-3970
Phone 50368479481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH61062285WAMDMental Health Counselor
C1097ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Randi Weber, LPC PC Mental Health CurrentSince Nov 12, 2023 Accepting new patients

Locations

4800 S Macadam Ave
Ste 350
Portland, OR 97239
Phone (503) 297-6656

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1366546913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 S MACADAM AVE STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393970",
            "telephone_number": "503-684-7948",
            "fax_number": "503-715-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S MACADAM AVE STE 350",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393970",
            "telephone_number": "503-684-7948",
            "fax_number": "503-715-1830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "SHERYL",
        "middle_name": "DUNN",
        "credential": "LPC, LMHC, CCMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1097",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1097",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61062285",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "LH61062285",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.