Sean Alexander Mickelson, MS, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C6214 Issued in OR

Practice address

1515 Liberty St SE
Salem, OR 97302-4345

Phone

(503) 951-6280

Fax

(503) 468-3130

NPI assigned

Dec 16, 2014

Last updated

Jun 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Options Counseling Services of Oregon

  dba Options Counseling and Family Services

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1548275217
  NPD

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1992103451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024345",
            "telephone_number": "503-951-6280",
            "fax_number": "503-468-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 LIBERTY ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024345",
            "telephone_number": "503-951-6280",
            "fax_number": "503-468-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "SEAN",
        "middle_name": "ALEXANDER",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-16",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C6214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "wp.options.org",
            "affiliation": "N",
            "address_1": "3500 Chad Dr Ste 350",
            "city": "Eugene",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974087602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rodney Douglas Michaels, MD
• Monica Michelotti
• Geary Joe Michels, D.C.
• Connie Jo Mickelson, RD, LD
• Ryan Amos Mickelson, PHARMD, BCPS
• Micronesian Islander Community
• Mid Valley Counseling Center Inc
• Mid Valley Employees Benefit Trust
• Mid Valley Medical Home LLC (Mid Valley Physicians Home Health)
• Mid Valley SRTF LLC

• Professional Counselor in Salem, OR
• Providers in Salem, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.