Active NPI
Therese N Mastin, M.A., QMHP
- Professional Counselor
- Cottage Grove, OR
National Provider Identifier
1003059296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C8458
- Practice address
- 1345 Birch Ave
Cottage Grove, OR 97424-1416 - Phone
- (541) 942-3939
- Fax
- (541) 942-9310
- NPI assigned
- Apr 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C8458 | OR | Primary |
Addresses
Primary practice location
1345 Birch Ave
Cottage Grove, OR 97424-1416
Mailing address
410 N 9TH St
PO Box 5
Cottage Grove, OR 97424-1307
Phone (541) 942-2850
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019047 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1345 Birch Ave
Cottage Grove, OR 97424-1416
Phone (541) 942-3939
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Cottage Grove, OR
- NPI 1306905831
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1003059296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 N 9TH ST",
"address_2": "PO BOX 5",
"city": "COTTAGE GROVE",
"state": "OR",
"postal_code": "974241307",
"telephone_number": "541-942-2850",
"fax_number": "541-942-1574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 BIRCH AVE",
"city": "COTTAGE GROVE",
"state": "OR",
"postal_code": "974241416",
"telephone_number": "541-942-3939",
"fax_number": "541-942-9310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASTIN",
"first_name": "THERESE",
"middle_name": "N",
"credential": "M.A., QMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-17",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C8458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019047",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cottage Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.