Active NPI
Emily Culbertson, CADC II, QMHA II
- Addiction (Substance Use Disorder) Counselor
- Redmond, OR
National Provider Identifier
1013387042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 23-08-20311
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 23-QMHA-II-000113 | OR | MD | Mental Health Counselor |
| 14-CRM-076 | OR | MD | Social 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.