Individual provider Active NPI

Robert T. Kurlychek, PH.D.

  • Clinical Psychologist
  • Eugene, OR
National Provider Identifier
1164591343
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0433 Issued in OR
Practice address
132 E Broadway
Suite 301
Eugene, OR 97401-3143
Phone
(541) 343-4626
Fax
(541) 343-0610
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 0433 OR
Clinical Psychologist 103TC0700X 0433 OR Primary

Addresses

Primary practice location

132 E Broadway
Suite 301
Eugene, OR 97401-3143

Mailing address

132 E Broadway
Suite 301
Eugene, OR 97401-3143
Phone (541) 343-4626

Other identifiers 1

IdentifierTypeStateIssuer
225268MedicaidOR

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

LicenseStateTypeSpecialty
0433ORMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1164591343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY",
            "address_2": "SUITE 301",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013143",
            "telephone_number": "541-343-4626",
            "fax_number": "541-343-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E BROADWAY",
            "address_2": "SUITE 301",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013143",
            "telephone_number": "541-343-4626",
            "fax_number": "541-343-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURLYCHEK",
        "first_name": "ROBERT",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "0433",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "0433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225268",
            "state": "OR"
        }
    ],
    "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 11, 2025; 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.