Mike C Theodore, QMHA - Counselor in Beaverton, OR

Mike C Theodore, QMHA is a Counselor - Addiction (substance Use Disorder) based in Beaverton, Oregon. Mike C Theodore is licensed to practice in New York (license number 35007) and his current practice location is 17933 Nw Evergreen Pkwy Ste 111, Beaverton, Oregon. He can be reached at his office (for appointments etc.) via phone at (814) 243-0414.

NPI number for Mike C Theodore is 1316644735 and his current mailing address is 3159 Carpenters Park Rd, Davidsville, Pennsylvania. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1316644735.

Contact Information

Mike C Theodore, QMHA
17933 Nw Evergreen Pkwy Ste 111,
Beaverton, OR 97006-7452
(814) 243-0414
(814) 479-5906

Map and Direction


Healthcare Provider's Profile

Full NameMike C Theodore
GenderMale
SpecialityCounselor - Addiction (substance Use Disorder)
Location17933 Nw Evergreen Pkwy Ste 111, Beaverton, Oregon
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1316644735
  • Provider Enumeration Date: 02/15/2023
  • Last Update Date: 02/15/2023

Medical Identifiers

Medical identifiers for Mike C Theodore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316644735NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YA0400XCounselor - Addiction (substance Use Disorder) 35007 (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mike C Theodore is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mike C Theodore, QMHA
3159 Carpenters Park Rd,
Davidsville, PA 15928-9223

Ph: (814) 243-0414
Mike C Theodore, QMHA
17933 Nw Evergreen Pkwy Ste 111,
Beaverton, OR 97006-7452

Ph: (814) 243-0414

Reviews and Comments


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