Individual
MR. STEVEN MICHAEL KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., CADC, QMHP
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 629-8517
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 629-8517
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
02-07-31
OR
101YM0800X
Mental Health Counselor
20-QMHP-R-0444
OR
Other
Enumeration date
08/02/2010
Last updated
11/13/2020
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