Portland Opioid Health Home (NPI# 1841855301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1841855301 |
| Entity Type | Organization |
| Organization Name | PORTLAND OPIOID HEALTH HOME |
| Practice Address |
48 Free St. Mezzanine Level Portland ME 04101 |
| Practice Telephone | 2078081384 |
| Practice Fax Number | 2072211710 |
| Mailing Address |
48 Free St. Mezzanine Level Portland ME 04101 |
| Mailing Telephone | 2078081384 |
| Mailing Fax Number | 2072211710 |
| Authorized Official Name | Constance W Jordan (CEO) |
| Authorized Official Telephone | 2078081384 |
| Authorized Official Credential | NP |
| Organization Subpart | No, this organization is not a Subpart |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-05-09 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 101YA0400X | Counselor · Addiction (Substance Use Disorder) | Behavioral Health & Social Service Providers |
| State | Identifier | Issuer | Type Code |
|---|---|---|---|
| ME | 193200000X | MEDICAID |
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477163657 | Kevin Charles Reiser | Counselor | 2318 Ne Martin Luther King Blvd, Portland, OR 97212-3715 | 2020-08-03 |
| 1881203628 | Beau Curtiss | Counselor | 7916 Se Foster Rd Ste 203, Portland, OR 97206-4289 | 2020-07-28 |
| 1851916886 | Jonathan Cross | Counselor | 49 Montrose Ave Apt 3, Portland, ME 04103-2442 | 2020-06-16 |
| 1639703960 | Elizabeth Ann Anderson | Counselor | 1820 Sw Vermont St Ste J, Portland, OR 97219-1945 | 2020-02-25 |
| 1194356618 | Deforrest Kwesi Jackson | Counselor | 122 Ne 122nd Ave Ste 200, Portland, OR 97230-2103 | 2020-02-03 |
| 1760012942 | Jesse Decker | Counselor | 7015 N Boston Ave, Portland, OR 97217-5711 | 2020-01-16 |
| 1740829076 | Ryan Christianson | Counselor | 2707 Ne Flanders St, Portland, OR 97232-3159 | 2020-01-03 |
| 1083264477 | Kayla Rose Paris | Counselor | 420 Cumberland Ave, Portland, ME 04101-2823 | 2019-09-17 |
| 1275193260 | Anna Khval | Counselor | 1500 Se 122nd Ave, Portland, OR 97233-1207 | 2019-06-20 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| Find all providers in PORTLAND | ||||
| Street Address |
48 FREE ST. MEZZANINE LEVEL |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851996987 | Karen Tinkham | Pharmacist | 2r 295 Forest Ave., Portland, ME 04101 | 2020-12-04 |
| 1669076121 | Dawn Lisowski | Pharmacist | 2r 295 Forest Ave, Hannaford Plaza, Portland, ME 04101 | 2020-11-25 |
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| Find all providers in zip 04101 | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.