Individual provider Active NPI

Acacia Huynh D'Antoni

  • Addiction (Substance Use Disorder) Counselor
  • Portland, OR
National Provider Identifier
1972240711
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1427 SE 182ND Ave
Portland, OR 97233-5008
Phone
(503) 761-6006
Fax
(503) 761-1434
NPI assigned
May 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

1427 SE 182ND Ave
Portland, OR 97233-5008

Mailing address

1027 E Burnside St
Portland, OR 97214-1328
Phone (503) 239-8400

Other identifiers 1

IdentifierTypeStateIssuer
941735271MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adantoni@telecarecorp.com

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coda, Inc. CurrentSince Sep 4, 2022 Accepting new patients
Coda, Inc. Addiction (Substance Use Disorder) CurrentSince Sep 4, 2022 Accepting new patients

Locations

1027 E Burnside St
Portland, OR 97214

Organizations & group practices 2

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": "1652400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1972240711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141328",
            "telephone_number": "503-239-8400",
            "fax_number": "503-239-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1427 SE 182ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335008",
            "telephone_number": "503-761-6006",
            "fax_number": "503-761-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'ANTONI",
        "first_name": "ACACIA",
        "middle_name": "HUYNH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-13",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "941735271",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adantoni@telecarecorp.com",
            "affiliation": "N",
            "address_1": "805 SE 151st Ave",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972332916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.