Active NPI
Matt Allen Johnston, LPC, CADC II
- Addiction (Substance Use Disorder) Counselor
- Portland, OR
National Provider Identifier
1568739746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 10-03-45U
- Practice address
- 722 N Sumner St
Portland, OR 97217-2641 - Phone
- (719) 319-3649
- NPI assigned
- Nov 16, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 10-03-45U | OR | Primary |
Addresses
Primary practice location
722 N Sumner St
Portland, OR 97217-2641
Mailing address
8004 N Interstate Ave
Portland, OR 97217-6631
Phone (971) 319-3649
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240116002823 | OR | Practitioner - Mental Health Counselor | 7315399284 | Practice locations: Portland, OR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714089600000",
"number": "1568739746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8004 N INTERSTATE AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972176631",
"telephone_number": "971-319-3649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 N SUMNER ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972172641",
"telephone_number": "719-319-3649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "MATT",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"credential": "LPC, CADC II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-11-16",
"last_updated": "2024-04-26",
"certification_date": "2024-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "10-03-45U",
"primary": true
}
],
"identifiers": [],
"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 Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.