MR. NATHANIEL RICHARD CONKLIN QMHA CLINICAL COUNS NPI 1811261506

NPI Information

NPI: 1811261506
Provider Name: MR. NATHANIEL RICHARD CONKLIN, QMHA, CLINICAL COUNS
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
847 NE 19TH AVE STE 100
PORTLAND, OR
ZIP 97232
Phone: (503) 238-0769
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MR. Nathaniel Richard Conklin, QMHA, CLINICAL COUNS is an addiction (substance use disorder) counselor in Portland, OR. MR. Nathaniel Richard Conklin, QMHA, CLINICAL COUNS NPI is 1811261506. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

847 NE 19TH AVE STE 100
PORTLAND, OR
ZIP 97232-684
Phone: (503) 238-0769
Fax: (503) 238-0769

The enumeration date for this NPI number is 2/28/2012 and was last updated on 4/11/2017.

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	390200000X	Student in an Organized Health Care Education/Training Program				No
2	101YM0800X	Counselor	Mental Health	CADCII: 13-12-54	OREGON	No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CADC II, 13-12-54	OREGON	Yes

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: 11/14/2023

NPI Synchronization or Removal

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