Jennie Teresa Maceachern

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L11729 Issued in OR

Practice address

913 NW Garden Valley Blvd
Roseburg, OR 97471-6523

Phone

(541) 440-1000

Fax

(541) 440-1000

NPI assigned

Oct 20, 2020

Last updated

Apr 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Roseburg Therapy LLC

  • Mental Health Counselor
  • Roseburg, OR
  • NPI 1538665013
  Medicare reassignment
• Rogue Psych Consultants, LLC

  • Mental Health Counselor
  • Ashland, OR
  • NPI 1447727110
  NPD
• Rogue Psych Consultants

  • Psychologist
  • Ashland, OR
  • NPI 1164094124
  NPD (past)

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1104425305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716523",
            "telephone_number": "541-440-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716523",
            "telephone_number": "541-440-1000",
            "fax_number": "541-440-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEACHERN",
        "first_name": "JENNIE",
        "middle_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-20",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11729",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Caleb Mabray, LPC
• Aaron Christopher Macarthur
• Esther Maccratic, PAC
• Michelle Nanette Macdannald, RN
• Jerimiah Macdonald, PT
• Amber Macpherson
• Deborah J Madden, MD
• Joaquina Rainbow Madison, CRM II, PSS
• Candice Kay Maidens
• Karen L Main

• Clinical Social Worker in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.