Gerald Todd Flynn, CADC II

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

12-12-75 Issued in OR

Practice address

1316 SE 12TH Ave
Portland, OR 97214-3604

Phone

(503) 897-1916

NPI assigned

Dec 1, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Hope Center Recovery LLC

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1316721418
  NPD Authorized official
• Premiere Recovery Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Clackamas, OR
  • NPI 1942981493
  NPD Authorized official

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

{
    "created_epoch": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1366985707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2135 NW 160TH AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067614",
            "telephone_number": "503-332-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 SE 12TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143604",
            "telephone_number": "503-897-1916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "GERALD",
        "middle_name": "TODD",
        "credential": "CADC II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-01",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "12-12-75",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Esther Zoe Flynn-Purvis, MSW
• Alana Flynn, CRM
• Brittny Alxindreeia Flynn
• Daniel Flynn, LMT
• Devon Flynn, PHARMD, BCPS
• Jessica Mary Flynn, MD
• Michael Joseph Flynn, MS
• Patricia Lamb Flynn, MSW, LCSW
• Thomas Francis Flynn, MD
• Tracy Flynn

• 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 Dec 1, 2016; 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.