Jill/ Ellen Conrad, M.A., L.M.F.T

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T0731 Issued in OR

Practice address

1300 Broadway St. NE
Ste # 409
Salem, OR 97301-9730

Phone

(503) 370-8050

NPI assigned

Dec 1, 2010

Last updated

Dec 1, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salem Pastoral Counseling CenterGroup PAC ID 3577902287, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

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

• Salem Pastoral Counseling Center

  • Marriage & Family Therapist
  • Salem, OR
  • NPI 1992842850
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291161600000",
    "number": "1174825855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BROADWAY STREET NE SUITE #409",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-370-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BROADWAY ST. NE",
            "address_2": "STE # 409",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973019730",
            "telephone_number": "503-370-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "JILL/",
        "middle_name": "ELLEN",
        "credential": "M.A., L.M.F.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abbi Connelly
• Timothy John Connelly
• Colleen Elizabeth Conner
• Denise Elaine Conner, PMHNP
• Kevin Patrick Connolly, M.D.
• Suzanne S Conrad, ARNP
• Continental Medical Equipment & Supplies LLC
• Gudelia Contreras Flores
• Deborah Conway, QMHP
• James Matthew Conway

• Marriage & Family Therapist in Salem, OR
• Providers in Salem, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.