Myranda Chantel Summers

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

4211 W 11TH Ave
Eugene, OR 97402-5435

Phone

(541) 485-1577

NPI assigned

Sep 14, 2021

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Addiction Counseling and Education Services Inc.

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1780712851

  Addiction (Substance Use Disorder)

  NPD (past)
• Serenity Lane

  • Substance Abuse Rehabilitation Facility
  • Coburg, OR
  • NPI 1104934892
  NPD (past)

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1194495952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 W 11TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025435",
            "telephone_number": "541-485-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 W 11TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974025435",
            "telephone_number": "541-485-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "MYRANDA",
        "middle_name": "CHANTEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariah Wynne Beck Sullivan
• Nina Noella Sullivan, LMT
• Ashton Sulzer, LMT
• Keith D Sumey, MD
• Kimberly Anne Summerhays, LPC, QMHP
• Candace Sumner
• Ivan Kent Sumner, LCSW
• Xiaoning Sun
• Julia N. E. Sunkomat, M.D.
• Sunny Mae Saul LLC

• Addiction (Substance Use Disorder) Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.