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Shyra Q Wade , CSWA, QMHA-I

Social Worker β€’ Gresham, OR

Active NPI 1689029365 Individual Practitioner Female Practitioner
Practice location in NPPES

620 Ne 2nd St
Gresham, OR 970307514

Call 9712743757 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

620 Ne 2nd St

Gresham, OR 970307514

Telephone 9712743757
Fax 5039125740
Organization at the Same NPPES Address or Phone
Native American Rehabilitation Assoc Inc Facility NPI 1942747761

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2016

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Gresham and Oregon

25 active clinicians are listed under Social Worker with a practice address in Gresham, OR (2,104 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Gresham

0% of these 25 clinicians have the CMS telehealth indicator.

0% of these 25 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-08-01
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

License # reported to NPPES OR A13083

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

License # reported to NPPES OR 19-QMHA-I-01324
Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
500760476 (OR)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Amy Berg , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1205204799

Psychiatric-Mental Health Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

24 Historical Events
πŸ‘€
Provider Name / Credentials Updated November 01, 2022

Recorded as SHYRA WADE, CSWA/QMHA-I

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 01, 2022

Counselor (license number reported to NPPES: OR 19-QMHA-I-01324)

πŸ“
Updated Practice Location July 29, 2022

Registered at 620 NE 2ND ST, GRESHAM, OR 970307514 (Tel: 9712743757)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 29, 2022

Social Worker (license number reported to NPPES: OR A13083)

πŸ‘€
Provider Name / Credentials Updated February 07, 2022

Recorded as SHYRA WADE, CSWA/PSS/QMHA-I

πŸ‘€
Provider Name / Credentials Updated October 19, 2021

Recorded as SHYRA WADE, PSS/QMHA-I

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 19, 2021

Peer Specialist (license number reported to NPPES: OR THW000001257)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 25, 2021

Counselor (license number reported to NPPES: OR 15-CRM-180)

πŸ‘€
Provider Name / Credentials Updated May 30, 2019

Recorded as SHYRA WADE, CRM/PSS/QMHA-I

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 30, 2019

Counselor (license number reported to NPPES: OR 19-QMHA-I-01324)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 17, 2019

Counselor

πŸ“
Updated Practice Location March 11, 2019

Registered at 1310 SW 17TH AVE, PORTLAND, OR 972012522 (Tel: 5032312641)

πŸ‘€
Provider Name / Credentials Updated March 11, 2019

Recorded as SHYRA WADE, CRM/PSS/QMHA

βœ…
NPI Profile Active May 31, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Business Mailing Address May 31, 2017

Registered at 1776 SW MADISON ST, PORTLAND, OR 972051715 (Tel: 9713862278)

πŸ“
Updated Practice Location May 31, 2017

Registered at 1631 SW COLUMBIA ST, PORTLAND, OR 972016025 (Tel: 5032312641)

πŸ‘€
Provider Name / Credentials Updated May 31, 2017

Recorded as SHYRA WADE, CRM/PSS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 31, 2017

Counselor (license number reported to NPPES: OR 15-CRM-180)

βœ…
NPI Profile Active May 02, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 02, 2016

Registered at 1631 SW COLUMBIA ST, PORTLAND, OR 972016025 (Tel: 5032312641)

πŸ“
Business Mailing Address (Initial Record) May 02, 2016

Registered at 13424 NE SANDY BLVD, APT H4, PORTLAND, OR 972302686 (Tel: 9712129206)

πŸ‘€
Provider Name / Credentials (Initial Record) May 02, 2016

Recorded as SHYRA WADE, CRM

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 02, 2016

Counselor (license number reported to NPPES: OR 15-CRM-180)

🟒
Initial NPI Registration & Enumeration April 29, 2016

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1689029365
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 29, 2016
Last Update: August 01, 2023
Sole Proprietor: No

Mailing Address

1776 Sw Madison St

Portland, OR 972051715

Phone: 5032241044

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.