NPIMap

Individual provider Active NPI

Amanda Matteo

  • Addiction (Substance Use Disorder) Counselor
  • Portland, OR
National Provider Identifier
1639680374
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
20 NE 10TH Ave
Portland, OR 97232
Phone
(503) 239-8400
NPI assigned
Oct 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

20 NE 10TH Ave
Portland, OR 97232

Mailing address

1027 E Burnside St
Portland, OR 97214-1328
Phone (503) 239-8400

Other practice location 1

2640 NW Alexandra Ave
Portland, OR 97210-1289
Phone (503) 731-3985

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coda, Inc. Addiction (Substance Use Disorder) CurrentSince Nov 10, 2019 Accepting new patients
Coda, Inc. CurrentSince Feb 9, 2020 Accepting new patients
The Salvation Army Past Accepting new patients
White Shield Center Counselor Past Accepting new patients

Locations

1027 E Burnside St
Portland, OR 97214

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1639680374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 NE 10TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97232",
            "telephone_number": "503-239-8400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2640 NW Alexandra Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972101289",
            "country_code": "US",
            "telephone_number": "503-731-3985",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATTEO",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-20",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "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 Nov 4, 2019; 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.