Individual provider Active NPI

Andrew Joseph Diffenderfer, B.S. PSYCHOLOGY

  • Mental Health Counselor
  • Eugene, OR
National Provider Identifier
1073949608
Registry record updated Sep 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
499 W 4TH Ave
Eugene, OR 97401-2505
Phone
(541) 686-1262
NPI assigned
Sep 14, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

499 W 4TH Ave
Eugene, OR 97401-2505

Mailing address

4300 Goodpasture Loop Apt 66
Eugene, OR 97401-1417
Phone (541) 844-8771

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
Credentials
Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1379116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379116800000",
    "number": "1073949608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 GOODPASTURE LOOP APT 66",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974011417",
            "telephone_number": "541-844-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 W 4TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012505",
            "telephone_number": "541-686-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFFENDERFER",
        "first_name": "ANDREW",
        "middle_name": "JOSEPH",
        "credential": "B.S. PSYCHOLOGY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-14",
        "last_updated": "2013-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2013; 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.