Individual provider Active NPI

Melinda Del Rio Quinones-Miranda, LCSW, CADC III, QMHP

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1386170835
Registry record updated May 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11390 Issued in OR
Practice address
7215 SE Harney St
Portland, OR 97206-8645
Phone
(503) 839-0733
NPI assigned
May 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 24-04-30104 OR
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 23-QMHPC-001235 OR
Clinical Social Worker 1041C0700X L11390 OR Primary

Addresses

Primary practice location

7215 SE Harney St
Portland, OR 97206-8645

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170

Other names 1

  • Melinda Del Rio Professional name

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
I20250317001812 OR Practitioner - Clinical Social Worker 3971030537 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23-QMHPC-001235ORMDMental Health Counselor
L11390ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Larsen Sanchez Psychology, LLC CurrentSince Dec 24, 2024 Accepting new patients
Diagnostic Imaging Associates Inc Past Accepting new patients

Locations

905 SE 14th Ave
Portland, OR 97214
Phone (503) 622-8964

698 12th St SE
Ste 145
Salem, OR 97301
Phone (503) 588-2674

Organizations & group practices 2

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": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1386170835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 HEATHROW WAY",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975044004",
            "telephone_number": "541-858-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7215 SE HARNEY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972068645",
            "telephone_number": "503-839-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL RIO QUINONES-MIRANDA",
        "first_name": "MELINDA",
        "credential": "LCSW, CADC III, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "24-04-30104",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "23-QMHPC-001235",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "DEL RIO",
            "credential": "LCSW, CADC III, QMHP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.