Individual provider Active NPI

Perry Collonge, MA, LMFT

  • Marriage & Family Therapist
  • Ashland, OR
National Provider Identifier
1245873918
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1285 Issued in OR
Practice address
408 N Laurel St
Ashland, OR 97520-1113
Phone
(408) 656-1219
NPI assigned
Oct 24, 2019
Last updated
Apr 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T1285 OR Primary

Addresses

Primary practice location

408 N Laurel St
Ashland, OR 97520-1113

Mailing address

408 N Laurel St
Ashland, OR 97520-1113
Phone (408) 656-1219

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ashland Health Information Exchange (HIE)

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
T1285ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rogue Resilience Counseling Marriage & Family Therapist CurrentSince Apr 26, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1245873918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N LAUREL ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201113",
            "telephone_number": "408-656-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N LAUREL ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201113",
            "telephone_number": "408-656-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLONGE",
        "first_name": "PERRY",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-24",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ashland",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "408 N Laurel St",
            "city": "Ashland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975201113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.