Individual provider Active NPI

Jenelle M'Lou Braun Stone, MA, MS, MS, PH.D. -

  • Counselor
  • Eugene, OR
National Provider Identifier
1033697768
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
C6324 Issued in OR
Practice address
132 E Broadway
Ste 332
Eugene, OR 97401-3154
Phone
(541) 915-1600
Fax
(541) 359-4433
NPI assigned
Aug 3, 2018
Last updated
Mar 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X C4926 OR
Counselor 101Y00000X C6324 OR Primary
Counseling Psychologist 103TC1900X C4926 OR
School Psychologist 103TS0200X TSPC10501134 OR

Addresses

Primary practice location

132 E Broadway
Ste 332
Eugene, OR 97401-3154

Mailing address

88701 Fisher Rd.
Eugene, OR 97402-9392
Phone (541) 915-1600

Other names 1

  • Jenelle M'Lou Braun-Monegan Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131003415 OR Practitioner - Mental Health Counselor 4486007952 Practice locations: Eugene, OR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
C4926ORMDCounseling Psychologist
TSPC10501134ORMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1533254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1033697768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88701 FISHER RD.",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974029392",
            "telephone_number": "541-915-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY",
            "address_2": "STE 332",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013154",
            "telephone_number": "541-915-1600",
            "fax_number": "541-359-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STONE",
        "first_name": "JENELLE",
        "middle_name": "M'LOU BRAUN",
        "name_prefix": "Mrs.",
        "credential": "MA, MS, MS, PH.D. -",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-03",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C4926",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "C6324",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OR",
            "license": "C4926",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OR",
            "license": "TSPC10501134",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENELLE",
            "last_name": "BRAUN-MONEGAN",
            "middle_name": "M'LOU",
            "credential": "MA, MS, MS, PH.D. -",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.