Elijah Andersen, CRM, CADC-R
Counselor, Addiction (Substance Use Disorder) in Gresham, OR. Individual provider (NPI-1).
NPI number1649063116
StatusActive
Last updated in NPPESNov 5, 2026
Details
- NPI
- 1649063116
- Entity type
- Individual (NPI-1)
- Name
- Elijah Andersen
- Credential
- CRM, CADC-R
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 27, 2025
- Certification date
- Nov 5, 2026
- Last updated
- Nov 5, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | T-26-7019 | OR | Yes |
| 175T00000X | Peer Specialist | 24-CRM-3164 | OR |
Practice location
1217 Ne Burnside Rd Ste 701Gresham, OR 97030-5770
Phone 503-740-1971 · Fax 503-771-2436
Mailing address
10117 Se Sunnyside Rd # F1217Clackamas, OR 97015-7708
Phone 503-740-1971 · Fax 503-771-2436
Other practice locations
9123 Se Saint Helens St Ste 100f
Clackamas, OR 97015-6800
Clackamas, OR 97015-6800
Phone 503-740-1971 · Fax 503-771-2436
14355 N Bybee Lake Ct
Portland, OR 97203-6495
Portland, OR 97203-6495
Phone 503-740-1971 · Fax 503-771-2436
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All 87 Addiction (Substance Use Disorder) Counselor providers in Gresham · All 2,430 providers in Gresham
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