Active NPI
Gary Borjesson
- Mental Health Counselor
- Ashland, OR
National Provider Identifier
1114644531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C5021
- Practice address
- 184 Clear Creek Dr Ste 1
Ashland, OR 97520-1977 - Phone
- (541) 236-4437
- NPI assigned
- Oct 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 101YM0800X | OR | |
| Professional Counselor | 101YP2500X | C5021 | OR | |
| Mental Health Counselor | 101YM0800X | C5021 | OR | Primary |
Addresses
Primary practice location
184 Clear Creek Dr Ste 1
Ashland, OR 97520-1977
Mailing address
184 Clear Creek Dr Ste 1
Ashland, OR 97520-1977
Phone (541) 236-4437
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | garyborjesson@protonmail.com | Health Information Exchange (HIE) |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101YM0800X | OR | MD | Mental Health Counselor |
| C5021 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1114644531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "184 CLEAR CREEK DR STE 1",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201977",
"telephone_number": "541-236-4437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 CLEAR CREEK DR STE 1",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201977",
"telephone_number": "541-236-4437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORJESSON",
"first_name": "GARY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-10-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "101YM0800X",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C5021",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C5021",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "garyborjesson@protonmail.com",
"affiliation": "N",
"endpointDescription": "professional email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "184 Clear Creek Dr Ste 1",
"city": "Ashland",
"state": "OR",
"country_code": "US",
"postal_code": "975201977",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.