Active NPI
Colleen C Odell, M.S., L.P.C
- Professional Counselor
- Portland, OR
National Provider Identifier
1629243217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C2159
- Practice address
- 1033 SW Yamhill St
Suite 401
Portland, OR 97205-2545 - Phone
- (503) 545-6312
- Fax
- (503) 575-9162
- NPI assigned
- Apr 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C2159 | OR | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C2159 | OR | |
| Professional Counselor | 101YP2500X | C2159 | OR | Primary |
| Counselor | 101Y00000X | C2159 | OR |
Addresses
Primary practice location
1033 SW Yamhill St
Suite 401
Portland, OR 97205-2545
Mailing address
1033 SW Yamhill St
Suite 401
Portland, OR 97205-2545
Phone (503) 545-6312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C2159 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480464000000",
"number": "1629243217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1033 SW YAMHILL ST",
"address_2": "SUITE 401",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972052545",
"telephone_number": "503-545-6312",
"fax_number": "503-575-9162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 SW YAMHILL ST",
"address_2": "SUITE 401",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972052545",
"telephone_number": "503-545-6312",
"fax_number": "503-575-9162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ODELL",
"first_name": "COLLEEN",
"middle_name": "C",
"name_prefix": "Ms.",
"credential": "M.S., L.P.C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-24",
"last_updated": "2016-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C2159",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "C2159",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C2159",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "C2159",
"primary": false
}
],
"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 Nov 30, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.