Dietrich Lamont McDaniel, CADCII/CRM/PSS/QMHAI

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

22-11-20216 Issued in OR

Practice address

620 NE 2ND St
Gresham, OR 97030-7514

Phone

(971) 274-3757

Fax

(503) 912-5740

NPI assigned

May 30, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Volunteers of America

  • Case Management Agency
  • Portland, OR
  • NPI 1558897710
  NPD (past)
• Volunteers of America Inc.

  dba Volunteers Of America Of Oregon Inc.

  • Contractor
  • Portland, OR
  • NPI 1376611418
  NPD (past)

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1548752199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 SW MADISON ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051715",
            "telephone_number": "503-224-1044",
            "fax_number": "971-260-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NE 2ND ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307514",
            "telephone_number": "971-274-3757",
            "fax_number": "503-912-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "DIETRICH",
        "middle_name": "LAMONT",
        "credential": "CADCII/CRM/PSS/QMHAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "17-CRM-068",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "23-QMHA-I-003592",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000001862",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "22-11-20216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn McCollum, RN
• Catherine Elizabeth McCoy, OTR/L OTD
• McCrae Management & Investments, LTD. (NewSound Hearing Aid Centers)
• Bryhanna Christinecharles McCully, PAC
• Cheryl Renee McDaniel, RDH
• Tilden McDonald Jr., CRM/PSS
• Courtney McEldowney, L.M.T
• Dani McFarland
• Ann McFarlane
• Annette McGahey, LMT

• Addiction (Substance Use Disorder) Counselor in Gresham, OR
• Providers in Gresham, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.