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General NPI Number Information
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NPI Number | 1942087929
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Entity Type | Individual
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Provider Name | JD AKOBIAN CADC-I, QMHA-I
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Gender | Male
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Dates
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Enumeration Date | 09/12/2023
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 251 SW ALDER ST
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City | PORTLAND
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State | OR
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Zip | 97204-3105
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Country | US
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Telephone | 818-669-0892
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Fax |
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Provider Business Mailing Address
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Address Line | 123 NW 12TH AVE APT 630
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City | PORTLAND
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State | OR
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Zip | 97209-4147
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Country | US
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Telephone | 818-669-0892
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 24-05-1127
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 24-QMHA-I-004580
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License Number State | OR
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