Active NPI
Jackson County Child Abuse Task Force Inc
- Mental Health Counselor
- Medford, OR
National Provider Identifier
1114594264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- JACKSON COUNTY CHILD ABUSE TASK FORCE INC
- Practice address
- 816 West 10TH Street
Medford, OR 97501 - Phone
- (541) 734-5437
- Fax
- (541) 618-1094
- NPI assigned
- Jun 8, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tammi Pitzen
- Title
- Executive Director
- Phone
- (541) 494-1762
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
816 West 10TH Street
Medford, OR 97501
Mailing address
816 W. 10TH Street
Medford, OR 97501
Phone (541) 734-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232518 | Medicaid | OR |
National Provider Directory
National Provider Directory- Tax ID family
- Child Advocacy Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adolescent and Children Mental Health Clinic/Center
- Medford, OR
- NPI 1063585065
Locations
816 W 10th St
Medford, OR 97501
Phone (541) 734-5437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623110400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1749600000000",
"number": "1114594264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "816 W. 10TH STREET",
"city": "MEDFORD",
"state": "OR",
"postal_code": "97501",
"telephone_number": "541-734-5437",
"fax_number": "541-618-1094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 WEST 10TH STREET",
"city": "MEDFORD",
"state": "OR",
"postal_code": "97501",
"telephone_number": "541-734-5437",
"fax_number": "541-618-1094"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JACKSON COUNTY CHILD ABUSE TASK FORCE INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-08",
"last_updated": "2025-06-11",
"certification_date": "2025-06-11",
"status": "A",
"authorized_official_last_name": "PITZEN",
"authorized_official_first_name": "TAMMI",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "541-494-1762"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "232518",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.