SAM DAVID GILLAM
NPI 1083871743
Counselor in Portland, OR

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

Active since May 20, 2008

2410 SE 121ST AVE, PORTLAND, OR 97216(503) 335-5975 Get Directions Write a Review

NPPES record last updated: May 20, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Sam David Gillam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAM DAVID GILLAM (NPI 1083871743) is an individual counselor in Portland, Oregon and active in the NPI registry since May 2008.

NPPES Registry Identity

NPI1083871743

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameSAM DAVID GILLAM

Location Address2410 SE 121ST AVEPortland, OR 97216-4066

Mailing Address5815 Sw 59th CtPortland, OR 97221-1062 · (503) 334-6205

Phone(503) 335-5975

Sole ProprietorNo

Enumeration DateMay 20, 2008

✔ NPI 1083871743 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

2410 SE 121ST AVE, Portland, OR 97216

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