IndividualActive
Michael Smith- Fernandez, LCSW
NPI 1154788065 · Mental Health Counselor · Winston, OR
Provider details
- NPI number
- 1154788065
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- License
- L10476 (OR)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
4 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11 Sw Brantley Dr
Winston, OR 97496-4526
Phone: (541) 679-0366
Fax: (541) 679-4821
Street-level locationGet directions
Mailing address
11 Sw Brantley Dr
Winston, OR 97496-4526
Additional practice locations (3)
- 3099 Ne Diamond Lake BlvdRoseburg, OR 97470-3655Phone: (541) 673-3469
- 3099 Ne Diamond Lake BlvdRoseburg, OR 97470-3655Phone: (541) 673-3469
- 1652 Nw Hughwood CtRoseburg, OR 97471-8844Phone: (541) 673-3985Fax: (541) 673-8060
Registry dates
- Enumerated
- 2016-01-22
- Last updated
- 2021-01-25
- Certified
- 2021-01-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.