Individual provider Active NPI

John Schreurs, MA, PCA, CADC-R

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1992262067
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R8747 Issued in OR
Practice address
15 N Morris St
Portland, OR 97227-1541
Phone
(503) 445-7699
NPI assigned
Feb 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T-24-3960 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X P-1905 NE
Mental Health Counselor 101YM0800X 12710 NE
Mental Health Counselor 101YM0800X R8747 OR Primary

Addresses

Primary practice location

15 N Morris St
Portland, OR 97227-1541

Mailing address

15 N Morris St
Portland, OR 97227-1541
Phone (503) 445-7699

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
P-1905NEMDAddiction (Substance Use Disorder) Counselor
T-24-3960ORMDAddiction (Substance Use Disorder) Counselor
R8747ORMDMental Health Counselor
12710NEMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1992262067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 N MORRIS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271541",
            "telephone_number": "503-445-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 N MORRIS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271541",
            "telephone_number": "503-445-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHREURS",
        "first_name": "JOHN",
        "credential": "MA, PCA, CADC-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-25",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-24-3960",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "P-1905",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12710",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R8747",
            "primary": true
        }
    ],
    "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 Jun 4, 2024; 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.