NPIMap

Organization Active NPI

Madrone Mental Health Services, LLC

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1124400908
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6505 Issued in OR
Legal business name
MADRONE MENTAL HEALTH SERVICES, LLC
Practice address
150 Shelton McMurphey Blvd Ste 101
Eugene, OR 97401-5015
Phone
(541) 210-8090
NPI assigned
Jun 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Authorized official

Name
Dr. Bradley P Cohn, PHDNPI 1942417829
Title
Co-Director
Phone
(541) 210-8090

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X L6505 OR Primary

Addresses

Primary practice location

150 Shelton McMurphey Blvd Ste 101
Eugene, OR 97401-5015

Mailing address

150 Shelton McMurphey Blvd
Ste 101
Eugene, OR 97401-5015

National Provider Directory

National Provider Directory

Locations

150 Shelton McMurphey Blvd
Ste 101
Eugene, OR 97401
Phone (541) 210-5438

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1124400908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SHELTON MCMURPHEY BLVD",
            "address_2": "STE 101",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SHELTON MCMURPHEY BLVD STE 101",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015015",
            "telephone_number": "541-210-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONE MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "COHN",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "541-210-8090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6505",
            "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 Sep 1, 2015; 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.