Mr Michael Russell Revell, LPC - Counselor in Portland, OR

Mr Michael Russell Revell, LPC is a Counselor - Mental Health based in Portland, Oregon. Mr Michael Russell Revell is licensed to practice in Oregon (license number C6991) and his current practice location is 3811 Sw Troy St, Portland, Oregon. He can be reached at his office (for appointments etc.) via phone at (503) 479-8605.

NPI number for Mr Michael Russell Revell is 1053757880 and his current mailing address is 3811 Sw Troy St, Portland, Oregon. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1053757880.

Contact Information

Mr Michael Russell Revell, LPC
3811 Sw Troy St,
Portland, OR 97219-1664
(503) 479-8605
(971) 339-7047

Map and Direction


Healthcare Provider's Profile

Full NameMr Michael Russell Revell
GenderMale
SpecialityCounselor - Mental Health
Location3811 Sw Troy St, Portland, Oregon
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1053757880
  • Provider Enumeration Date: 05/20/2013
  • Last Update Date: 03/06/2023

Medical Identifiers

Medical identifiers for Mr Michael Russell Revell such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053757880NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101Y00000XCounselor 60961479 (Washington)Secondary
101Y00000XCounselor 6991 (Oregon)Secondary
101Y00000XCounselor R6261 (Oregon)Secondary
101Y00000XCounselor C6991 (Oregon)Secondary
101YM0800XCounselor - Mental Health R6261 (Oregon)Secondary
101YP2500XCounselor - Professional 6991 (Oregon)Secondary
101YP2500XCounselor - Professional C6991 (Oregon)Secondary
171M00000XCase Manager/care Coordinator (* (Not Available))Secondary
101YM0800XCounselor - Mental Health C6991 (Oregon)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. Mr Michael Russell Revell 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
Mr Michael Russell Revell, LPC
3811 Sw Troy St,
Portland, OR 97219-1664

Ph: (503) 479-8605
Mr Michael Russell Revell, LPC
3811 Sw Troy St,
Portland, OR 97219-1664

Ph: (503) 479-8605

Reviews and Comments


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