Gretchen Carmack

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

105 E Hilliard LN
Eugene, OR 97404-3222

Phone

(541) 780-6836

Fax

(541) 653-8646

NPI assigned

Sep 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1043824394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 N 6TH ST",
            "city": "CRESWELL",
            "state": "OR",
            "postal_code": "974269623",
            "telephone_number": "541-604-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E HILLIARD LN",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974043222",
            "telephone_number": "541-780-6836",
            "fax_number": "541-653-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMACK",
        "first_name": "GRETCHEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://elrodcenter.org/",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "105 E Hilliard Ln",
            "city": "Eugene",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974043222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abbey Carlstrom
• David A Carlstrom, D.C.
• Douglas Paul Carlstrom, D.C.
• Tyler Carlton
• Carly M. Peterschmidt, DMD, LLC
• Brad Carmichael, MS.ED, LPC, NCC
• Laurie C Carmichael, PNP
• Robert Alan Carmichael, DDS PC
• Michael Anthony Carnevale, D.O.
• Berkley Ann Carnine

• Mental Health Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.