Tedra Stuart, LPC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

859573 Issued in OR

Practice address

3406 Watermark Dr
Springfield, OR 97477-6725

Phone

(503) 798-0706

NPI assigned

Sep 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Options Counseling Services of Oregon

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1548275217
  NPD (past)

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

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1104076140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 WATERMARK DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974776725",
            "telephone_number": "503-798-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 WATERMARK DR",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974776725",
            "telephone_number": "503-798-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "TEDRA",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1334",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1334",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "OR",
            "license": "859573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "859573",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth L Stover, MD
• Brittney Regala Stratton, LMT
• Rachel Grace Straub, MA
• Isabella Perry Stretch-Mendoza, QMHA-I, CHW
• Elizabeth Anne Strubel, P.A.
• Marta Stueve, PHARMD
• Chantia Nicole Sturman, LMFT
• Hemalatha Subbaratnam, M.D.
• Rama Subedi, MD
• Ronald Maximo Suguitan, PHARMD

• In Home Supportive Care Agency in Springfield, OR
• Providers in Springfield, OR by specialty
• In Home Supportive Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.