Organization Active NPI

Neuropsychological Services of Oregon, LLC

  • Clinical Neuropsychologist
  • Creswell, OR
National Provider Identifier
1164820478
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
2524 Issued in OR
Legal business name
NEUROPSYCHOLOGICAL SERVICES OF OREGON, LLC
Practice address
170 Melton Rd
Creswell, OR 97426-9453
Phone
(541) 306-6456
Fax
(541) 647-1580
NPI assigned
Dec 18, 2014
Last updated
Jan 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Authorized official

Name
Tracy N Kreiling, PSYDNPI 1659682177
Title
Owner
Phone
(541) 306-6456

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 2524 OR Primary
Psychologist 103T00000X 2524 OR
Clinical Psychologist 103TC0700X

Addresses

Primary practice location

170 Melton Rd
Creswell, OR 97426-9453

Mailing address

PO Box 249
Creswell, OR 97426-0249
Phone (541) 306-6456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150306002286 OR Part B Supplier - Clinic/Group Practice 1658697701 Receives reassigned benefits from 1 practitioner
Practice locations: Creswell, OR

National Provider Directory

National Provider Directory

Locations

231 SW Scalehouse Loop
Ste 203
Bend, OR 97702
Phone (541) 306-6456

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768953600000",
    "number": "1164820478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "CRESWELL",
            "state": "OR",
            "postal_code": "974260249",
            "telephone_number": "541-306-6456",
            "fax_number": "541-647-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MELTON RD",
            "city": "CRESWELL",
            "state": "OR",
            "postal_code": "974269453",
            "telephone_number": "541-306-6456",
            "fax_number": "541-647-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGICAL SERVICES OF OREGON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A",
        "authorized_official_last_name": "KREILING",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-306-6456",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "2524",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2524",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creswell, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.