Individual provider Active NPI

Charlene Michelle Negus Shemley, LPC, CADC II

  • Professional Counselor
  • Portland, OR
National Provider Identifier
1669705018
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C4025 Issued in OR
Practice address
9450 SW Barnes Rd Ste 200
Portland, OR 97225-6638
Phone
(503) 216-3511
Fax
(503) 216-5529
NPI assigned
Sep 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12-12-79U OR
Professional Counselor 101YP2500X C4025 OR Primary

Addresses

Primary practice location

9450 SW Barnes Rd Ste 200
Portland, OR 97225-6638

Mailing address

9450 SW Barnes Rd Ste 200
Portland, OR 97225-6638
Phone (503) 216-3511

Other names 1

  • Charlene Michelle Negus Former name

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
I20240104001669 OR Practitioner - Mental Health Counselor 1557712536 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 1, 2024 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2024 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2024 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 1, 2024 Accepting new patients

Locations

9155 SW Barnes Rd
Ste 409
Portland, OR 97225
Phone (503) 216-1234

5228 NE Hoyt St
Bldg B
Portland, OR 97213
Phone (503) 215-4860

9450 SW Barnes Rd
Ste 200
Portland, OR 97225
Phone (503) 216-2025

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

4805 NE Glisan St
Portland, OR 97213
Phone (503) 215-1111

Organizations & group practices 7

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": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1669705018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9450 SW BARNES RD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256638",
            "telephone_number": "503-216-3511",
            "fax_number": "503-216-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 SW BARNES RD STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256638",
            "telephone_number": "503-216-3511",
            "fax_number": "503-216-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGUS SHEMLEY",
        "first_name": "CHARLENE",
        "middle_name": "MICHELLE",
        "credential": "LPC, CADC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "12-12-79U",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C4025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLENE",
            "last_name": "NEGUS",
            "middle_name": "MICHELLE",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.