Active NPI
Dylan Edwards
- Mental Health Counselor
- Enterprise, OR
National Provider Identifier
1508387747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 207 SW 1St St
Enterprise, OR 97828-1203 - Phone
- (541) 426-4524
- NPI assigned
- Jun 28, 2017
- Last updated
- Apr 18, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | OR | Primary | |
| Case Manager/Care Coordinator | 171M00000X | 19-QMHA-I-02381 | OR |
Addresses
Primary practice location
207 SW 1St St
Enterprise, OR 97828-1203
Mailing address
PO Box 268
Enterprise, OR 97828-0268
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 |
|---|---|---|---|
| 19-QMHA-I-02381 | OR | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1508387747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 268",
"city": "ENTERPRISE",
"state": "OR",
"postal_code": "978280268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 SW 1ST ST",
"city": "ENTERPRISE",
"state": "OR",
"postal_code": "978281203",
"telephone_number": "541-426-4524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "DYLAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-28",
"last_updated": "2025-04-18",
"certification_date": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "OR",
"license": "19-QMHA-I-02381",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enterprise, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.