NPIMap

Organization Active NPI

VA

  • Addiction (Substance Use Disorder) Counselor
  • Roseburg, OR
National Provider Identifier
1235212986
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
VA
Practice address
913 NW Garden Valley Blvd
Roseburg, OR 97470-6513
Phone
(541) 440-1000
Fax
(541) 440-1273
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
George Marnell
Title
Director
Phone
(541) 440-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

913 NW Garden Valley Blvd
Roseburg, OR 97470-6513

Mailing address

1281 SE Magnolia Dr.
Roseburg, OR 97470-6513
Phone (541) 440-1000

National Provider Directory

National Provider Directory
Tax ID family
Roseburg Vamc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1235212986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 SE MAGNOLIA DR.",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974706513",
            "telephone_number": "541-440-1000",
            "fax_number": "541-440-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 NW GARDEN VALLEY BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974706513",
            "telephone_number": "541-440-1000",
            "fax_number": "541-440-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MARNELL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "541-440-1000"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.