Individual provider Active NPI

Ricky Shaun Delucco

  • Counselor
  • Portland, OR
National Provider Identifier
1972708394
Registry record updated Feb 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1304 N Emerson St Apt 5
Portland, OR 97217-3770
Phone
(503) 313-1299
NPI assigned
Jun 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Counselor 101Y00000X 372600000X OR

Addresses

Primary practice location

1304 N Emerson St Apt 5
Portland, OR 97217-3770

Mailing address

1304 N Emerson St Apt 5
Portland, OR 97217-3770
Phone (503) 313-1299

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
372600000XORMDAdult Companion

NPI Registry JSON

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

{
    "created_epoch": "1181952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233964800000",
    "number": "1972708394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 N EMERSON ST APT 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173770",
            "telephone_number": "503-313-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N EMERSON ST APT 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972173770",
            "telephone_number": "503-313-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUCCO",
        "first_name": "RICKY",
        "middle_name": "SHAUN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-16",
        "last_updated": "2009-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "372600000X",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Feb 7, 2009; 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.