Mcdaniel, Dietrich Lamont
Mcdaniel, Dietrich Lamont is an individual health care provider with primary practice located at 620 Ne 2Nd St , Gresham OR 97030-7514. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Mcdaniel, Dietrich Lamont can be contacted via phone (971) 274-3757.Contact Information
Primary practice address
620 Ne 2Nd St
Gresham OR 97030-7514
Phone: (971) 274-3757
Fax: (503) 912-5740
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 17-CRM-068 | Oregon |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 23-QMHA-I-003592 | Oregon |
| Other Service Providers / Peer Specialist | 175T00000X | THW000001862 | Oregon |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 22-11-20216 | Oregon |
Profile Details
| NPI number | 1548752199 |
|---|---|
| LBN Legal business name | Mcdaniel, Dietrich Lamont |
| Credentials | CADCII/CRM/PSS/QMHAI |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2018 |
| Last updated | Oct 15th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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