Addison McKenna Alexys Brown

Individual provider Active NPI Mental Health Counselor · Wilsonville, OR

NPI 1649006552 · NPPES record last updated Sep 9, 2024

Key facts

NPI
1649006552
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
29120 SW San Remo CT
Wilsonville, OR 97070-7373
Phone
(503) 682-1840
Fax
(503) 682-1873
NPI assigned
Sep 9, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Columbiacare Services Past
since Sep 15, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

29120 SW San Remo CT
Wilsonville, OR 97070-7373

Mailing address

3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 858-8170

Other providers in Wilsonville, OR

All providers in Wilsonville, OR · Mental Health Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.