Individual provider Active NPI

Renee L Perkins, CADC II/CGAC I

  • Addiction (Substance Use Disorder) Counselor
  • Gresham, OR
National Provider Identifier
1619412582
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
25-04-20563 Issued in OR
Practice address
355 NW Division St
Gresham, OR 97030-5523
Phone
(971) 225-6695
Fax
(503) 231-1654
NPI assigned
Dec 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X G21-01-07 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X 25-04-20563 OR Primary

Addresses

Primary practice location

355 NW Division St
Gresham, OR 97030-5523

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502
Phone (971) 386-2278

Other practice location 1

1631 SW Columbia St
Portland, OR 97201-6025
Phone (503) 231-2641

Other identifiers 1

IdentifierTypeStateIssuer
500718989MedicaidOR

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

NPI Registry JSON

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1619412582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE CARUTHERS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144502",
            "telephone_number": "971-386-2278",
            "fax_number": "503-224-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 NW DIVISION ST",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305523",
            "telephone_number": "971-225-6695",
            "fax_number": "503-231-1654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1631 SW Columbia St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972016025",
            "country_code": "US",
            "telephone_number": "503-231-2641",
            "fax_number": "503-231-1654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "RENEE",
        "middle_name": "L",
        "credential": "CADC II/CGAC I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-30",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "G21-01-07",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "25-04-20563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500718989",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.