Individual
CHEYENNE A CLEETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I/QMHA-R
Contact information
Practice address
1438 SE DIVISION ST, PORTLAND, OR 97202-1140
(503) 548-0346
(503) 232-5959
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20-07-01
OR
101YM0800X
Mental Health Counselor
22-QMHA-R-2712
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500769842
—
OR
05
—
500809541
—
OR
Enumeration date
07/10/2019
Last updated
10/07/2022
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