NPIMap

Organization Active NPI

New Avenues for Youth

  • Case Manager/Care Coordinator
  • Lake Oswego, OR
National Provider Identifier
1740844539
Registry record updated Jan 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Legal business name
NEW AVENUES FOR YOUTH
Practice address
2595 Christie Dr.
Lake Oswego, OR 97034
Phone
(503) 517-3973
Fax
(503) 517-3199
NPI assigned
Apr 26, 2019
Last updated
Jan 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2020

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

Authorized official

Name
Mr. Sean Suib, LCSW
Title
Executive Director
Phone
(503) 517-3921

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

2595 Christie Dr.
Lake Oswego, OR 97034

Mailing address

1220 SW Columbia Street
Portland, OR 97201
Phone (503) 224-4339

Other practice location 1

1220 SW Columbia Street
Portland, OR 97201
Phone (503) 224-4339

National Provider Directory

National Provider Directory

Locations

1220 SW Columbia St
Portland, OR 97201
Phone (503) 224-4339

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578873600000",
    "number": "1740844539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SW COLUMBIA STREET",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97201",
            "telephone_number": "503-224-4339",
            "fax_number": "503-501-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2595 CHRISTIE DR.",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97034",
            "telephone_number": "503-517-3973",
            "fax_number": "503-517-3199"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 SW Columbia Street",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97201",
            "country_code": "US",
            "telephone_number": "503-224-4339",
            "fax_number": "503-501-3198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW AVENUES FOR YOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-26",
        "last_updated": "2020-01-13",
        "certification_date": "2020-01-13",
        "status": "A",
        "authorized_official_last_name": "SUIB",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "503-517-3921",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2020; 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.