Sarah Jean Tedrick, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C5821 Issued in OR

Practice address

510 NE Roberts Ave Ste 200
Gresham, OR 97030-7484

Phone

(503) 300-6073

NPI assigned

Mar 24, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  OR

  Medicare reassignment
• Center Light Studio LLC

  • Professional Counselor
  • Happy Valley, OR
  • NPI 1205508918
  NPD

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1982281291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13424 SE 169TH AVE # A120",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970158744",
            "telephone_number": "503-960-2817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 NE ROBERTS AVE STE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307484",
            "telephone_number": "503-300-6073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDRICK",
        "first_name": "SARAH",
        "middle_name": "JEAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Canby",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "700 SE 5th Ave Apt A201",
            "city": "Canby",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970135501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew S Taylor, CSWA/QMHP
• Michaila N Taylor, QMHA
• Ronald Taylor, OTD, OTR/L
• Samantha K Taylor, CADC I/QMHA
• Carli Tedford
• Kristina Tee, D.D.S.
• Beniam Teklu, RN
• Telecare Mental Health Services of Oregon, Inc
• Telecare Mental Health Services of Oregon, Inc.
• Jennifer Tellez, LMT

• Mental Health Counselor in Gresham, OR
• Providers in Gresham, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.