Alfreda Tina Nimely, QMHA-R
Counselor, Mental Health in Portland, OR. Individual provider (NPI-1).
NPI number1609768712
StatusActive
Last updated in NPPESJul 15, 2025
Details
- NPI
- 1609768712
- Entity type
- Individual (NPI-1)
- Name
- Alfreda Tina Nimely
- Credential
- QMHA-R
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 15, 2025
- Certification date
- Jul 15, 2025
- Last updated
- Jul 15, 2025
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 |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
4949 S Landing Dr Unit 327Portland, OR 97239-5924
Phone 401-390-6629
Mailing address
4949 S Landing Dr Unit 327Portland, OR 97239-5924
Phone 401-390-6629
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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