Individual provider Active NPI

Michelle Donna Alcala, NON QMHA 106500000X

  • Counselor
  • Grants Pass, OR
National Provider Identifier
1114457546
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1750 Nebraska Ave
Grants Pass, OR 97527-5700
Phone
(541) 956-4943
Fax
(541) 956-5463
NPI assigned
Jun 18, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

1750 Nebraska Ave
Grants Pass, OR 97527-5700

Mailing address

715 SW Ramsey Ave
Grants Pass, OR 97527-5500
Phone (541) 956-4943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kairos Northwest CurrentSince Sep 4, 2022 Accepting new patients

Locations

1750 Nebraska Ave
Grants Pass, OR 97527
Phone (541) 474-5579

715 SW Ramsey Ave
Grants Pass, OR 97527
Phone (541) 474-5579

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": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114457546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275500",
            "telephone_number": "541-956-4943",
            "fax_number": "541-956-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 NEBRASKA AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275700",
            "telephone_number": "541-956-4943",
            "fax_number": "541-956-5463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCALA",
        "first_name": "MICHELLE",
        "middle_name": "DONNA",
        "credential": "NON QMHA 106500000X",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grants Pass, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.