Individual
AMY C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC, CRM, QMHA
Contact information
Practice address
17645 NW SAINT HELENS RD, PORTLAND, OR 97231-1729
(503) 621-1069
(503) 621-0200
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(971) 217-9008
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21-01-10037
OR
101YM0800X
Mental Health Counselor
23-QMHA-R-4488
OR
175T00000X
Peer Specialist
23-CRM-1940
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-07-17
MHACBO CADC-I
OR
01
—
21-01-10037
MHACBO CADC-II
OR
01
—
23-CRM-1940
MHACBO CRM
OR
05
—
500717291
—
OR
Enumeration date
11/01/2016
Last updated
04/28/2026
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