Individual provider Active NPI

Melinda Lee Herbaugh Conrad, MA PCA

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1639684400
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R12092 Issued in OR
Practice address
1706 NE 53Rd Ave
Portland, OR 97213-2740
Phone
(503) 662-9212
Fax
(503) 882-4564
NPI assigned
Dec 2, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R12092 OR Primary

Addresses

Primary practice location

1706 NE 53Rd Ave
Portland, OR 97213-2740

Mailing address

1706 NE 53Rd Ave
Portland, OR 97213-2740
Phone (503) 662-9212

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
R12092ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1512172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1639684400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 NE 53RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132740",
            "telephone_number": "503-662-9212",
            "fax_number": "503-882-4564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 NE 53RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132740",
            "telephone_number": "503-662-9212",
            "fax_number": "503-882-4564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "MELINDA",
        "middle_name": "LEE HERBAUGH",
        "credential": "MA PCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-02",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R12092",
            "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 Jan 7, 2026; 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.