Active NPI
Danielle Ashly McWilliams, LPC
- Mental Health Counselor
- Portland, OR
National Provider Identifier
1477212975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4219
- Practice address
- 1524 NW 23Rd Ave Ste D
Portland, OR 97210-2686 - Phone
- (503) 544-7631
- NPI assigned
- Dec 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4219 | OR | Primary |
Addresses
Primary practice location
1524 NW 23Rd Ave Ste D
Portland, OR 97210-2686
Mailing address
7523 SE Holgate Blvd
Portland, OR 97206-3359
Phone (503) 544-7631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22685842 | Other | BUSINESS TAX ID NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4219 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639267200000",
"number": "1477212975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7523 SE HOLGATE BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972063359",
"telephone_number": "503-544-7631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1524 NW 23RD AVE STE D",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972102686",
"telephone_number": "503-544-7631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCWILLIAMS",
"first_name": "DANIELLE",
"middle_name": "ASHLY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-12",
"last_updated": "2021-12-12",
"certification_date": "2021-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "4219",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUSINESS TAX ID NUMBER",
"identifier": "22685842",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.