Active NPI
Brett Anthony Vicario, PH. D.
- Counseling Psychologist
- Eugene, OR
National Provider Identifier
1114657129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 1694
- Practice address
- 374 W 12TH Ave
Eugene, OR 97401-1633 - Phone
- (541) 829-3105
- NPI assigned
- Jun 13, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 1694 | OR | Primary |
Addresses
Primary practice location
374 W 12TH Ave
Eugene, OR 97401-1633
Mailing address
2597 Garfield St
Eugene, OR 97405-6401
Phone (541) 829-3105
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1694 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673308800000",
"number": "1114657129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2597 GARFIELD ST",
"city": "EUGENE",
"state": "OR",
"postal_code": "974056401",
"telephone_number": "541-829-3105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 W 12TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974011633",
"telephone_number": "541-829-3105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VICARIO",
"first_name": "BRETT",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-13",
"last_updated": "2023-01-10",
"certification_date": "2023-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "OR",
"license": "1694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.