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NATHAN KENNELLY CRM, CADC R
NPI 1871304279
Counselor - Addiction (Substance Use Disorder) in Gresham, OR

Active since January 15, 2025
1217 NE BURNSIDE RD STE 701, GRESHAM, OR 97030(503) 740-6449 Get Directions Write a Review

NPPES record last updated: January 15, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nathan Kennelly Crm, Cadc R NPPES

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

NATHAN KENNELLY CRM, CADC R (NPI 1871304279) is an individual addiction (substance use disorder) provider in Gresham, Oregon and active in the NPI registry since January 2025.

NPPES Registry Identity

NPI1871304279
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameNATHAN KENNELLYCredential: CRM, CADC R
Location Address1217 NE BURNSIDE RD STE 701Gresham, OR 97030-5770
Mailing Address10117 Se Sunnyside Rd # F1217Clackamas, OR 97015-7708
Phone(503) 740-6449
Sole ProprietorNo
Enumeration DateJanuary 15, 2025
NPPES CertifiedJanuary 15, 2025
✔ NPI 1871304279 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
Also ListedPeer SpecialistTaxonomy 175T00000X
1217 NE BURNSIDE RD STE 701, Gresham, OR 97030
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Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KARISSA ROSE MATHEWS CRM
Peer Specialist
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 740-1971
BETHANIE WILSON CRM
Peer Specialist
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 740-1971
GWENDOLYN JOY KOCHAN LMT
Massage Therapist
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 665-8959
IZABELLA JOHNSON QMHA-SOCIAL WORK
Counselor (Mental Health)
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 740-1971
EASTON HALLOCK CADC II, QMHA II
Counselor (Addiction (Substance Use Disorder))
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 866-0877
AARON PETRARCA
Peer Specialist
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 740-1971
GOLDEN RIBBON ACUPUNCTURE, LLC
Clinic/Center (Health Service)
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 839-5510
SHANNON WELSH CRM, CADC
Counselor (Addiction (Substance Use Disorder))
1217 NE BURNSIDE RD STE 701
GRESHAM, OR 97030
Multnomah County (503) 866-0877

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nathan Kennelly's NPI number?

The NPI number for Nathan Kennelly is 1871304279. It was assigned to this individual provider in the NPPES registry on January 15, 2025.

Where is Nathan Kennelly located?

Nathan Kennelly practices at 1217 NE Burnside Rd Ste 701, Gresham, OR 97030. The listed phone number is (503) 740-6449.

What is Nathan Kennelly's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Nathan Kennelly was last updated on January 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.