Individual provider Active NPI

Suzanne Ruth Gascoyne, PHD

  • Counseling Psychologist
  • Eugene, OR
National Provider Identifier
1104962513
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
0718 Issued in OR
Practice address
3575 Donald St Ste 107
Eugene, OR 97405-4753
Phone
(541) 343-9058
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0718 OR
Counseling Psychologist 103TC1900X 0718 OR Primary

Addresses

Primary practice location

3575 Donald St Ste 107
Eugene, OR 97405-4753

Mailing address

PO Box 50591
Eugene, OR 97405-0985
Phone (541) 844-1834

Other practice location 1

1860 Willamette Ste
Ste B
Eugene, OR 97401
Phone (541) 343-1860

Other practice location 2

282 E 18th Ave
Eugene, OR 97401-4159
Phone (541) 844-1834

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
I20200401001121 OR Practitioner - Clinical Psychologist 8022072065 Practice locations: Eugene, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Virginia Commonwealth University, School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3575 Donald St
Suite 107
Eugene, OR 97405-4753
Phone (541) 844-1834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0718ORMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Marc Taylor PHD, Psychologist, P.C. Clinical Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1104962513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50591",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974050985",
            "telephone_number": "541-844-1834",
            "fax_number": "541-343-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 DONALD ST STE 107",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974054753",
            "telephone_number": "541-343-9058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 Willamette Ste",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "97401",
            "country_code": "US",
            "telephone_number": "541-343-1860",
            "fax_number": "541-343-9058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "282 E 18th Ave",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974014159",
            "country_code": "US",
            "telephone_number": "541-844-1834",
            "fax_number": "541-343-9058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GASCOYNE",
        "first_name": "SUZANNE",
        "middle_name": "RUTH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "0718",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OR",
            "license": "0718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.