Individual provider Active NPI

Monica G Radley

  • Mental Health Counselor
  • Cottage Grove, OR
National Provider Identifier
1144530726
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1345 Birch Ave.
Cottage Grove, OR 97424
Phone
(541) 942-3939
Fax
(541) 942-9310
NPI assigned
Oct 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1345 Birch Ave.
Cottage Grove, OR 97424

Mailing address

1117 E. Chamberlian Ave
Cottage Grove, OR 97424
Phone (541) 525-4034

Other identifiers 1

IdentifierTypeStateIssuer
019047MedicaidOR

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

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1144530726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 E. CHAMBERLIAN AVE",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "97424",
            "telephone_number": "541-525-4034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 BIRCH AVE.",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "97424",
            "telephone_number": "541-942-3939",
            "fax_number": "541-942-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADLEY",
        "first_name": "MONICA",
        "middle_name": "G",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019047",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.