Individual provider · Type 1 NPI

Dietrich Lamont McDaniel, CADCII/CRM/PSS/QMHAI

Addiction (Substance Use Disorder) Counselor · Gresham, OR

NPI number 1548752199 Active

Practice location

620 NE 2nd St
Gresham, OR 97030-7514

Fax (503) 912-5740

Mailing address

1776 SW Madison St
Portland, OR 97205-1715

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X17-CRM-068 (OR)
Mental Health Counselor 101YM0800X23-QMHA-I-003592 (OR)
Peer Specialist 175T00000XTHW000001862 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X22-11-20216 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1548752199

Dietrich Lamont McDaniel, CADCII/CRM/PSS/QMHAI's National Provider Identifier is 1548752199, issued on May 30, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Gresham, OR. The record was last updated on Oct 15, 2024.