Individual provider Active NPI

Jeff Glaudin

  • Mental Health Counselor
  • Astoria, OR
National Provider Identifier
1093082398
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
115 W Bond St
Astoria, OR 97103-6009
Phone
(503) 325-5722
NPI assigned
Nov 30, 2011
Last updated
Jun 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Social Worker 104100000X NU

Addresses

Primary practice location

115 W Bond St
Astoria, OR 97103-6009

Mailing address

65 N Highway 101 Ste 204
Warrenton, OR 97146-9371

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
I20241213002690 OR Practitioner - Clinical Social Worker 9234665225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Clatsop Behavioral HealthcareGroup PAC ID 1355336454, 9 clinicians

Practice addresses (Care Compare)

115 W Bond St
Astoria, OR 97103-6009
Phone 5033255722268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clatsop Behavioral Healthcare CurrentSince Nov 11, 2024 Accepting new patients

Locations

115 W Bond St
Astoria, OR 97103

65 N Highway 101
Ste 204
Warrenton, OR 97146

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/clatsopbh/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1093082398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 N HIGHWAY 101 STE 204",
            "city": "WARRENTON",
            "state": "OR",
            "postal_code": "971469371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W BOND ST",
            "city": "ASTORIA",
            "state": "OR",
            "postal_code": "971036009",
            "telephone_number": "503-325-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAUDIN",
        "first_name": "JEFF",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, OR

Sources for this page

Verify at the official NPI Registry.