Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1548752199 Individual Practitioner Male Practitioner

Dietrich Lamont Mcdaniel , CADCII, CRM, PSS, QMHAI

Counselor - Addiction (Substance Use Disorder) • Gresham, OR

Professional Overview & Biography Verified Profile Summary

Dietrich Mcdaniel, CADCII, CRM, PSS, QMHAI is a registered healthcare professional specializing in Counselor - Addiction (Substance Use Disorder) in Gresham, OR. Practice services are available at 620 NE 2ND ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

620 Ne 2nd St

Gresham, OR 970307514

Telephone 9712743757
Fax 5039125740
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Addiction (Substance Use Disorder) in Gresham, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 11.1 Yrs
Regional Practice Density
83 Specialists

Practicing in Gresham, OR (4216 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-15
Counselor - Addiction (Substance Use Disorder) Primary Specialty

NUCC Taxonomy Code: 101YA0400X

State License OR 22-11-20216

Definition to come...

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

State License OR 17-CRM-068

Definition to come...

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

State License OR 23-QMHA-I-003592

Definition to come...

Peer Specialist

NUCC Taxonomy Code: 175T00000X

State License OR THW000001862

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Kathy Litvin , CSWA, QMHP-C

Counselor - Mental Health

NPI 1003213737

CSWA, QMHPC

Elizabeth Valadez , CRM, PSS

Counselor - Addiction (Substance Use Disorder)

NPI 1013765569
Christina Collier , QMHA-I

Counselor - Mental Health

NPI 1023570397

QMHAI

Jessica Trailer , QMHA-I

Counselor - Mental Health

NPI 1033758479

QMHAI

Danielle Curtis , CRM-II CADC-I QMHA-R

Counselor - Addiction (Substance Use Disorder)

NPI 1063209914

CRMIICADCIQMHAR

NPI 1073060083

CADCR, CSWA

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Business Mailing Address October 15, 2024

Registered at 1776 SW MADISON ST, PORTLAND, OR 972051715 (Tel: 5032241044)

👤
Provider Name / Credentials Updated October 15, 2024

Recorded as DIETRICH MCDANIEL, CADCII/CRM/PSS/QMHAI

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2024

Counselor (License #17-CRM-068 in OR)

📍
Updated Practice Location October 04, 2024

Registered at 620 NE 2ND ST, GRESHAM, OR 970307514 (Tel: 9712743757)

📍
Updated Business Mailing Address October 04, 2024

Registered at 620 NE 2ND ST, GRESHAM, OR 970307514 (Tel: 9712743757)

👤
Provider Name / Credentials Updated October 04, 2024

Recorded as DIETRICH MCDANIEL, CADC 2

NPI Profile Active May 30, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location May 30, 2018

Registered at 10564 SE WASHINGTON ST, PORTLAND, OR 972162809 (Tel: 9713228231)

📍
Updated Business Mailing Address May 30, 2018

Registered at 10564 SE WASHINGTON ST, PORTLAND, OR 972162809 (Tel: 9713228231)

👤
Provider Name / Credentials Updated May 30, 2018

Recorded as DIETRICH MCDANIEL, CRM

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 30, 2018

Peer Specialist (License #17-CRM-068 in OR)

🟢
Initial NPI Registration & Enumeration May 30, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1548752199
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 30, 2018
Last Update: October 15, 2024
Sole Proprietor: No

Mailing Address

1776 Sw Madison St

Portland, OR 972051715

Phone: 5032241044

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.