Elisabeth Ruth Decelles, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201902988NP-PP Issued in OR

Practice address

1233 Edgewater St NW
Salem, OR 97304-4049

Phone

(503) 378-7526

NPI assigned

Jan 16, 2018

Last updated

Nov 27, 2023By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of South Alabama College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Human Services IncGroup PAC ID 7012825797, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elisabeth.decelles.p1@direct.nwhumanservices.nextgenshare.com

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.

• Northwest Human Services, Inc.

  dba West Salem Clinic

  • Federally Qualified Health Center (FQHC)
  • Salem, OR
  • NPI 1871530758
  Medicare reassignment Care Compare group NPD
• Northwest Human Services, Inc.

  dba Quick Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Salem, OR
  • NPI 1497014914
  NPD
• Changepoint Integrated Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Holbrook, AZ
  • NPI 1205877610
  NPD (past)
• Changepoint Integrated Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Winslow, AZ
  • NPI 1750525978
  NPD (past)

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1114435807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 E SHOW LOW LAKE RD BLDG B",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017929",
            "telephone_number": "928-537-2951",
            "fax_number": "928-537-2071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 EDGEWATER ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044049",
            "telephone_number": "503-378-7526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 E Show Low Lake Rd Bldg B",
            "address_purpose": "LOCATION",
            "city": "Show Low",
            "state": "AZ",
            "postal_code": "859017929",
            "country_code": "US",
            "telephone_number": "928-537-2951",
            "fax_number": "928-537-2071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECELLES",
        "first_name": "ELISABETH",
        "middle_name": "RUTH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP10900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201902988NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elisabeth.decelles.p1@direct.nwhumanservices.nextgenshare.com",
            "affiliation": "Y",
            "affiliationName": "Northwest Human Services, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1233 Edgewater St NW",
            "city": "Salem",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973044049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deborah M Johnson MD PC
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• Lindsey Decampos-Stairiker, DPT
• Catherine Elaine Decampos, PSY.D./FNP-BC
• Melissa Decarlo
• Jordan Marissa Decker, M.ED., BCBA, LBA
• Cynthia Vermillion Deckert, NURSE
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• Kathryn Marie Deeds, CADC CANDIDATE
• Deep Currents Trauma Therapy

• Psychiatric/Mental Health Nurse Practitioner in Salem, OR
• Providers in Salem, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.