Individual provider Active NPI

Eric Joseph Pinkston, QMHP-C, CADC III

  • Mental Health Counselor
  • Milwaukie, OR
National Provider Identifier
1780250043
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R9017 Issued in OR
Practice address
15415 SE Woodland Way
Milwaukie, OR 97267-2742
Phone
(503) 744-1854
NPI assigned
May 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 21-03-20036 OR
Mental Health Counselor 101YM0800X R9017 OR Primary

Addresses

Primary practice location

15415 SE Woodland Way
Milwaukie, OR 97267-2742

Mailing address

15415 SE Woodland Way
Milwaukie, OR 97267-2742
Phone (503) 477-8495

Other practice location 1

6025 SE Belmont St
Portland, OR 97215-1927
Phone (503) 477-8495

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R9017ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Crestview Recovery Services, LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1780250043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15415 SE WOODLAND WAY",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972672742",
            "telephone_number": "503-477-8495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15415 SE WOODLAND WAY",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972672742",
            "telephone_number": "503-744-1854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6025 SE Belmont St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972151927",
            "country_code": "US",
            "telephone_number": "503-477-8495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINKSTON",
        "first_name": "ERIC",
        "middle_name": "JOSEPH",
        "credential": "QMHP-C, CADC III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-27",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "21-03-20036",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R9017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.