Provider Demographics
NPI:1043083546
Name:RABINOWITZ, JOHN (QMHP-C, CADC-III)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:RABINOWITZ
Suffix:
Gender:M
Credentials:QMHP-C, CADC-III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 N ALBINA AVE APT 409
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-2671
Mailing Address - Country:US
Mailing Address - Phone:312-914-0991
Mailing Address - Fax:
Practice Address - Street 1:4750 N ALBINA AVE APT 409
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-2671
Practice Address - Country:US
Practice Address - Phone:312-914-0991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22-QMHP-001190101YM0800X
OR24-06-30113101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health