Ellie Roberson
Counselor in Portland, OR. Individual provider (NPI-1).
NPI number1063010809
StatusActive
Last updated in NPPESApr 25, 2023
Details
- NPI
- 1063010809
- Entity type
- Individual (NPI-1)
- Name
- Ellie Roberson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 14, 2020
- Certification date
- Apr 25, 2023
- Last updated
- Apr 25, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
1904 Se Division StPortland, OR 97202-1146
Phone 503-517-8663
Mailing address
1904 Se Division StPortland, OR 97202-1146
Phone 503-517-8663
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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