Individual provider Active NPI

Collin Runge, NCC

  • Mental Health Counselor
  • Redmond, OR
National Provider Identifier
1174337885
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R10527 Issued in OR
Practice address
128 W Antler Ave
Redmond, OR 97756-1852
Phone
(541) 644-4618
NPI assigned
Feb 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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 R10527 OR Primary

Addresses

Primary practice location

128 W Antler Ave
Redmond, OR 97756-1852

Mailing address

2552 NW 19TH St
Redmond, OR 97756-7106
Phone (541) 419-1513

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
R10527ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1738540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1174337885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 NW 19TH ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567106",
            "telephone_number": "541-419-1513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W ANTLER AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561852",
            "telephone_number": "541-644-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNGE",
        "first_name": "COLLIN",
        "credential": "NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-03",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R10527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.