Individual provider Active NPI

Emily Culbertson, CADC II, QMHA II

  • Addiction (Substance Use Disorder) Counselor
  • Redmond, OR
National Provider Identifier
1013387042
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
23-08-20311 Issued in OR
Practice address
340 NW 5TH St
Box 1710
Redmond, OR 97756-1869
Phone
(540) 516-4087
Fax
(541) 504-1195
NPI assigned
Oct 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 23-QMHA-II-000113 OR
Social Worker 104100000X 14-CRM-076 OR
Addiction (Substance Use Disorder) Counselor 101YA0400X 23-08-20311 OR Primary

Addresses

Primary practice location

340 NW 5TH St
Box 1710
Redmond, OR 97756-1869

Mailing address

340 NW 5TH St
Box 1710
Redmond, OR 97756-1869
Phone (541) 516-4099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
23-QMHA-II-000113ORMDMental Health Counselor
14-CRM-076ORMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1013387042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 NW 5TH ST",
            "address_2": "BOX 1710",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561869",
            "telephone_number": "541-516-4099",
            "fax_number": "541-504-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW 5TH ST",
            "address_2": "BOX 1710",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561869",
            "telephone_number": "540-516-4087",
            "fax_number": "541-504-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULBERTSON",
        "first_name": "EMILY",
        "credential": "CADC II, QMHA II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-02",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "23-QMHA-II-000113",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OR",
            "license": "14-CRM-076",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "23-08-20311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.