Individual provider Active NPI

Rebecca Nicole Stock, CADC-I

  • Counselor
  • Portland, OR
National Provider Identifier
1649597923
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
14-11-13 Issued in OR
Practice address
33 NW Broadway
Portland, OR 97209-3580
Phone
(971) 271-6229
NPI assigned
Apr 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 14-11-13 OR Primary

Addresses

Primary practice location

33 NW Broadway
Portland, OR 97209-3580

Mailing address

232 NW 6TH Ave
Portland, OR 97209-3609
Phone (971) 271-6229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240115001176 OR Order and Referring Only - Mental Health Counselor 6305298472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465516800000",
    "number": "1649597923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093609",
            "telephone_number": "971-271-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 NW BROADWAY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093580",
            "telephone_number": "971-271-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCK",
        "first_name": "REBECCA",
        "middle_name": "NICOLE",
        "credential": "CADC-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2016-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "14-11-13",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.