Individual provider Active NPI

Camryn Conrad-Renteria, LCPC

  • Professional Counselor
  • Vale, OR
National Provider Identifier
1801174875
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C3940 Issued in OR
Practice address
789 Washington St W
Vale, OR 97918-1147
Phone
(541) 473-2101
Fax
(541) 473-2668
NPI assigned
Jul 25, 2011
Last updated
Jan 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C3940 OR Primary
Professional Counselor 101YP2500X LCPC-5843 ID

Addresses

Primary practice location

789 Washington St W
Vale, OR 97918-1147

Mailing address

1441 NE 10TH Ave
Payette, ID 83661-5420
Phone (208) 642-9376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240501003997 ID Practitioner - Mental Health Counselor 4587017496 Reassigns benefits to 1 organization
I20240502002557 OR Practitioner - Mental Health Counselor 4587017496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Family Health Care IncGroup PAC ID 0547169591, 45 clinicians

Practice addresses (Care Compare)

1441 NE 10TH Ave
Payette, ID 83661-5420
Phone (208) 642-9376

17 S 3Rd St
Nyssa, OR 97913-3815
Phone (541) 372-5738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCPC-5843IDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Family Health Care, Inc Current Accepting new patients
Valley Family Health Care Inc CurrentSince Mar 18, 2024 Accepting new patients
Valley Family Health Care, Inc CurrentSince Mar 18, 2024 Accepting new patients
Valley Family Health Care, Inc Past Accepting new patients
Valley Family Health Care, Inc Past Accepting new patients

Locations

207 E 12th St
Emmett, ID 83617
Phone (208) 365-1065

1441 NE 10th Ave
Payette, ID 83661
Phone (208) 642-9376

17 S 3rd St
Nyssa, OR 97913
Phone (541) 372-5738

2327 SW 4th Ave
Unit 3
Ontario, OR 97914
Phone (541) 889-2340

896 Fortner St
Ontario, OR 97914
Phone (541) 709-2038

789 Washington St W
Vale, OR 97918
Phone (503) 473-2101

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1801174875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 NE 10TH AVE",
            "city": "PAYETTE",
            "state": "ID",
            "postal_code": "836615420",
            "telephone_number": "208-642-9376",
            "fax_number": "208-642-9598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 WASHINGTON ST W",
            "city": "VALE",
            "state": "OR",
            "postal_code": "979181147",
            "telephone_number": "541-473-2101",
            "fax_number": "541-473-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD-RENTERIA",
        "first_name": "CAMRYN",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3940",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ID",
            "license": "LCPC-5843",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vale, OR

Sources for this page

Verify at the official NPI Registry.