Matthew M Block, MA LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

R3648 REG INTERN Issued in OR

Practice address

10011 SE Division St
Suite 203
Portland, OR 97266-1351

Phone

(503) 255-2343

Fax

(503) 255-2344

NPI assigned

Aug 19, 2015

Sex

Male

Sole proprietor

No

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

Credentials

Master of Arts

State licenses

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.

• Northwest ADHD Treatment Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1225459548
  NPD (past)

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

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1457727828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16308",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972920308",
            "telephone_number": "503-255-2343",
            "fax_number": "503-255-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10011 SE DIVISION ST",
            "address_2": "SUITE 203",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972661351",
            "telephone_number": "503-255-2343",
            "fax_number": "503-255-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "credential": "MA LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-19",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "R3648 REG INTERN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blkjade. Mental Wellness, LLC.
• Andrea Bloch
• Isaac Woods Bloch
• Pamela Jean Bloch
• Heather Block
• Megan Elizabeth Block, MD
• Michelle Marie Block, PSY.D.
• Rebecca G Block, LCSW, MSW, PHD
• Sarah Block, PHARMD
• Sarah C Block

• Professional Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2015; 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.