Active NPI
Gina Marie Tormohlen, MSW
- Mental Health Counselor
- Eugene, OR
National Provider Identifier
1033290028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2411 Martin Luther King Jr. Blvd.
Eugene, OR 97401 - Phone
- (541) 682-7593
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4854 | OR | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2411 Martin Luther King Jr. Blvd.
Eugene, OR 97401
Mailing address
987 W 5TH Ave
Eugene, OR 97402-5105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210604000473 | OR | Practitioner - Clinical Social Worker | 6901205335 | Practice locations: Eugene, OR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4854 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649289600000",
"number": "1033290028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "987 W 5TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974025105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2411 MARTIN LUTHER KING JR. BLVD.",
"city": "EUGENE",
"state": "OR",
"postal_code": "97401",
"telephone_number": "541-682-7593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TORMOHLEN",
"first_name": "GINA",
"middle_name": "MARIE",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2022-04-07",
"certification_date": "2022-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "4854",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
- Christina Tomaselli-Baird, LMT
- Matthew Ryan Tommack, D.O.
- Nancy Ann Tomooka, M.A., L.P.C.
- Joan Tompkins, MSW, LCSW, MAC
- Jennifer J Toney, M. ED.
- Guillermo Enrique Torres-Sanchez, ATC
- David Alexander Torres Sr., PSS , PWS R
- Hannah Christina Torres, LMT
- Jill Evelyn Torres, QMHP, MED
- Sydney A Tostenson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.