Mike Tierney, CADC II

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

14-03-33 Issued in OR

Practice address

3580 SE 82ND Ave
Portland, OR 97266-2902

Phone

(971) 339-9240

NPI assigned

Apr 11, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michael.tierney.p1@direct.grandronde.nextgenshare.com

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

• Confederated Tribes of the Grand Ronde Community of Oregon

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Grand Ronde, OR
  • NPI 1174666358

  Addiction (Substance Use Disorder)

  NPD
• Confederated Tribes of the Grand Ronde Community of Oregon

  • Land Ambulance
  • Grand Ronde, OR
  • NPI 1215606132
  NPD (past)

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1659735165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 NW DAVIS STREET",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972099720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 SE 82ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662902",
            "telephone_number": "971-339-9240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 NW Davis Street",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972099720",
            "country_code": "US",
            "telephone_number": "503-226-2203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "MIKE",
        "credential": "CADC II",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-11",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "14-03-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Mary Tidwell, RN
• Paige Tiedeman, TLLP
• Julia Tienson, MSW
• Danielle Djoumbi Tientcheu, M.D.
• Carrie Tierney
• Rhonda C Tierney, M.D.
• Chelsea R Tieszen, MD, MS
• Bao-Chau Tieu
• Brandon H Tieu, MD
• Tam Tieu, PA-C

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.