Individual provider Active NPI

Angel Breanna Kammeyer, LPC

  • Professional Counselor
  • Eugene, OR
National Provider Identifier
1144739749
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C7877 Issued in OR
Practice address
115 W 8TH Ave Ste 300
Eugene, OR 97401-2997
Phone
(541) 623-0262
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R7256 OR
Case Manager/Care Coordinator 171M00000X
Adult Companion 372600000X
Professional Counselor 101YP2500X C7877 OR Primary

Addresses

Primary practice location

115 W 8TH Ave Ste 300
Eugene, OR 97401-2997

Mailing address

1292 High St # 1025
Eugene, OR 97401-3238
Phone (541) 623-0262

Other identifiers 1

IdentifierTypeStateIssuer
500779668MedicaidOR

Other names 1

  • Angel Breanna Oliver Former name

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

LicenseStateTypeSpecialty
R7256ORMDMental Health Counselor
C7877ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Oregon Directions, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Oregon Directions, LLC Professional CurrentSince Jan 1, 2024 Accepting new patients
Selah Counseling & Wellness LLC Mental Health PastSince Mar 27, 2022 Accepting new patients

Locations

1705 Centennial Blvd
Ste 2
Springfield, OR 97477
Phone (970) 962-4819

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1144739749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1292 HIGH ST # 1025",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-623-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W 8TH AVE STE 300",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012997",
            "telephone_number": "541-623-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMEYER",
        "first_name": "ANGEL",
        "middle_name": "BREANNA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R7256",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C7877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500779668",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGEL",
            "last_name": "OLIVER",
            "middle_name": "BREANNA",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Dec 23, 2024; 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.