Organization Active NPI

Pacific Alcohol & Drug Counseling, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Hillsboro, OR
National Provider Identifier
1578840849
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
PACIFIC ALCOHOL & DRUG COUNSELING, INC.
Practice address
157 SE Baseline St
Suite a
Hillsboro, OR 97123
Phone
(503) 640-0110
Fax
(503) 640-0107
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Mrs. Jennifer A Wallenstein, CADC II
Title
Executive Director/Owner
Phone
(503) 640-0110

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary
Community/Behavioral Health Agency 251S00000X OAR4150510000 OR

Addresses

Primary practice location

157 SE Baseline St
Suite a
Hillsboro, OR 97123

Mailing address

157 SE Baseline St
Suite a
Hillsboro, OR 97123
Phone (503) 640-0110

National Provider Directory

National Provider Directory

Locations

157 SE Baseline St
Ste a
Hillsboro, OR 97123
Phone (503) 640-0110

12950 SW Pacific Hwy
Ste 235
Tigard, OR 97223
Phone (503) 624-9545

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1578840849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 SE BASELINE ST",
            "address_2": "SUITE A",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "97123",
            "telephone_number": "503-640-0110",
            "fax_number": "503-640-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 SE BASELINE ST",
            "address_2": "SUITE A",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "97123",
            "telephone_number": "503-640-0110",
            "fax_number": "503-640-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ALCOHOL & DRUG COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "WALLENSTEIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/OWNER",
        "authorized_official_telephone_number": "503-640-0110",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CADC II"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OR",
            "license": "OAR4150510000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.