NPIMap

Organization Active NPI

Streamside Counseling Center

  • Mental Health Counselor
  • Roseburg, OR
National Provider Identifier
1255431706
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C1635 Issued in OR
Legal business name
STREAMSIDE COUNSELING CENTER
Practice address
693 NE Stephens St
Suite a
Roseburg, OR 97470-3192
Phone
(541) 464-8700
Fax
(541) 464-8700
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Matthew Newey, M.A.NPI 1033210273
Title
Executive Director
Phone
(541) 784-6444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X C1635 OR Primary

Addresses

Primary practice location

693 NE Stephens St
Suite a
Roseburg, OR 97470-3192

Mailing address

693 NE Stephens St
Suite a
Roseburg, OR 97470-3192
Phone (541) 464-8700

National Provider Directory

National Provider Directory

Locations

693 NE Stephens St
Ste A
Roseburg, OR 97470
Phone (541) 464-8700

Practitioners & affiliated clinicians

Practitioners 2

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255431706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "693 NE STEPHENS ST",
            "address_2": "SUITE A",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703192",
            "telephone_number": "541-464-8700",
            "fax_number": "541-464-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "693 NE STEPHENS ST",
            "address_2": "SUITE A",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703192",
            "telephone_number": "541-464-8700",
            "fax_number": "541-464-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREAMSIDE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NEWEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-784-6444",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1635",
            "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 Aug 22, 2020; 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.