Active NPI
Patricia Stack Sampson
- Mental Health Counselor
- Stayton, OR
National Provider Identifier
1255834271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2340 Martin Dr Ste 103
Stayton, OR 97383-1672 - Phone
- (503) 509-5275
- Fax
- (503) 509-2933
- NPI assigned
- Mar 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2340 Martin Dr Ste 103
Stayton, OR 97383-1672
Mailing address
1732 N 6TH Ave
Stayton, OR 97383-1236
Phone (503) 580-9068
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521072000000",
"number": "1255834271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1732 N 6TH AVE",
"city": "STAYTON",
"state": "OR",
"postal_code": "973831236",
"telephone_number": "503-580-9068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2340 MARTIN DR STE 103",
"city": "STAYTON",
"state": "OR",
"postal_code": "973831672",
"telephone_number": "503-509-5275",
"fax_number": "503-509-2933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPSON",
"first_name": "PATRICIA",
"middle_name": "STACK",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-15",
"last_updated": "2018-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stayton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.