KELLY RAE STRIDER LPC CADC III NPI 1063717320

NPI Information

NPI: 1063717320
Provider Name: KELLY RAE STRIDER, LPC, CADC III
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
4405 NE 34TH AVE
PORTLAND, OR
ZIP 97211
Phone: (503) 704-5061
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Kelly Rae Strider, LPC, CADC III is a mental health counselor in Portland, OR. Kelly Rae Strider, LPC, CADC III NPI is 1063717320. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4405 NE 34TH AVE
PORTLAND, OR
ZIP 97211-728
Phone: (503) 704-5061

The enumeration date for this NPI number is 1/18/2011 and was last updated on 5/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	C2931	OREGON	Yes
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	10-12-49	OREGON	No
3	106H00000X	Marriage & Family Therapist		C2931	OREGON	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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