DEPAUL TREATMENT CENTER (NPI# 1346420338) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346420338 |
| Entity Type | Organization |
| Organization Name | DEPAUL TREATMENT CENTER |
| Practice Address |
4310 Ne Killingsworth St Portland OR 97218-1404 |
| Practice Telephone | 5035351181 |
| Practice Fax Number | 5035280800 |
| Mailing Telephone | 5035351181 |
| Mailing Fax Number | 5035280800 |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |
| Authorized Official Name | MR. JOSHUA HAMPTON (PRIMARY COUNSELOR) |
| Authorized Official Telephone | 5039281570 |
| Authorized Official Credential | M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689924722 | Depaul Treatment Center | Substance Abuse Rehabilitation Facility | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2012-09-17 |
| Street Address |
4310 NE KILLINGSWORTH ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97218-1404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922149699 | June Stinson Mccandless | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2007-02-08 |
| 1861022444 | Alexander Sundermeier | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2020-01-22 |
| 1144860966 | Nikki Laine Gray | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2020-01-09 |
| 1770148173 | Emily Miller Short | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2019-05-01 |
| 1417451220 | Stephanie Ann Burk | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2018-03-19 |
| 1649773417 | Ashley Cohen | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2018-03-17 |
| 1770007635 | Whitney Ann Fabrizio | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2017-08-01 |
| 1982125514 | Stefan Goldberg | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2017-07-05 |
| 1699202747 | Hansung Yang | Counselor | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2017-05-20 |
| 1689115719 | Lindsay Morris | Substance Abuse Rehabilitation Facility | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2017-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043852726 | Alex Margarito | Specialist/Technologist | 6801 Necornfoot Rd, Fpo, AA 97218 | 2019-10-14 |
| 1083101943 | Joyce M Larkins | Specialist | 5852 Ne 42nd Ave., Portland, OR 97218 | 2018-04-17 |
| 1740709658 | Alyssa M Cavalier | Licensed Practical Nurse | 6601 Ne 78th Ct., Suite A3, Portland, OR 97218 | 2017-09-12 |
| 1093266405 | Jean Hansen | Counselor | 6601ne 78th Court Suite, Suite A3, Portland, OR 97218 | 2016-10-20 |
| 1174913636 | Kirsten Kelly-chambers | Counselor | 4310 Ne Killinsworth Street, Portland, OR 97218 | 2015-02-04 |
| 1386962074 | Kathleen Kuhlmey Sheridan | Nurse Practitioner | 5215 Ne 52nd Ave, Portland, OR 97218 | 2010-05-06 |
| 1003049909 | Kevin Richardson | Adult Companion | 5029 Ne Killingsworth St, Portland, OR 97218 | 2009-08-26 |
| 1366676462 | Bobbi Gabriele Kennedy | Military Health Care Provider | 6801 Ne Cornfoot Road, Portland, OR 97218 | 2009-05-05 |
| 1396980751 | Jamie Mercile Taylor | Counselor | 4310 N.e Kilingsworth, Portland, OR 97218 | 2008-12-12 |
| 1902041460 | Brandi Danielle Hess | Counselor | 4450 Ne 76th, Portland, OR 97218 | 2008-12-11 |
| Find all providers in zip 97218 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821205246 | Gail Renee Wilson | Substance Abuse Rehabilitation Facility | 2614 Se 115th Ave Apt 2, Portland, OR 97266-1176 | 2007-05-16 |
| 1396186607 | Richard Ivan Vaughan | Substance Abuse Rehabilitation Facility | 4310 Ne Killingsworth St, Portland, OR 97208-3007 | 2013-07-15 |
| 1689924722 | Depaul Treatment Center | Substance Abuse Rehabilitation Facility | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2012-09-17 |
| 1417277021 | De Paul Treatment Center | Substance Abuse Rehabilitation Facility | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2010-06-04 |
| 1548407646 | Kelsey Corrine Coffey | Substance Abuse Rehabilitation Facility | 1500 Ne Irving St, Suite 250, Portland, OR 97232-2243 | 2009-01-11 |
| 1841318581 | Depaul Youth and Family | Substance Abuse Rehabilitation Facility | 4310 Ne Killingsworth St, Portland, OR 97218-1404 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467885145 | Klamath County Juvenile Department | Substance Abuse Rehabilitation Facility | 3331 Vandenberg Rd, Klamath Falls, OR 97603-3730 | 2013-08-16 |
| 1740543297 | Marion County Health Department | Substance Abuse Rehabilitation Facility | 3529 Fisher Rd Ne, Salem, OR 97305 | 2012-06-20 |
| 1972864759 | New Directions Northwest, Inc. | Substance Abuse Rehabilitation Facility | 3700 Midway Drive, Baker City, OR 97814 | 2012-06-07 |
| 1578864641 | Klamath Tribal Health & Family Services | Substance Abuse Rehabilitation Facility | 121 Iowa St., Klamath Falls, OR 97601 | 2010-11-05 |
| 1023322690 | The Northstar Center | Substance Abuse Rehabilitation Facility | 1195 Nw Wall St, Bend, OR 97701-1965 | 2010-08-05 |
| 1811215478 | Rimrock Trails Adolescent Treatment Services | Substance Abuse Rehabilitation Facility | 16360 1st Street, La Pine, OR 97739-0305 | 2010-05-06 |
| 1730362534 | Adapt | Substance Abuse Rehabilitation Facility | 2064 Se Douglas Ave, Roseburg, OR 97470-3713 | 2007-12-14 |
| 1851753123 | Dalana Sewell | Substance Abuse Rehabilitation Facility | 234 W 5th St, Medford, OR 97501-2611 | 2016-03-24 |
| 1225403744 | Looking Glass Community Services - Pathways Boys | Substance Abuse Rehabilitation Facility | 550 River Rd, Eugene, OR 97404-3212 | 2015-12-09 |
| 1265866305 | Hillcrest Youth Correctional Facility-oregon Youth Authority | Substance Abuse Rehabilitation Facility | 2450 Strong Rd Se, Salem, OR 97302-9676 | 2013-08-26 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DEPAUL TREATMENT CENTER.
| 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.