Active NPI
Danielle Mancuso
- Mental Health Counselor
- Medford, OR
National Provider Identifier
1265167381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 931 Chevy Way
Medford, OR 97504-4127 - Phone
- (541) 535-6239
- NPI assigned
- Jul 21, 2022
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
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
931 Chevy Way
Medford, OR 97504-4127
Mailing address
931 Chevy Way
Medford, OR 97504-4127
Other practice location 1
400 W Hersey St Ste 4
Ashland, OR 97520-1854
Phone (541) 631-9446
Other practice location 2
1307 W Main St
Medford, OR 97501-2936
Phone (541) 535-6239
Other practice location 3
3617 S Pacific Hwy
Medford, OR 97501-8957
Phone (541) 535-6239
Other practice location 4
730 Biddle Rd
Medford, OR 97504-6116
Phone (541) 535-6239
Other practice location 5
4940 Hamrick Rd
Central Point, OR 97502-3072
Phone (541) 535-6239
Other practice location 6
910 S Central Ave
Medford, OR 97501-7854
Phone (541) 535-6239
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": "1658361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1265167381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "931 CHEVY WAY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "931 CHEVY WAY",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975044127",
"telephone_number": "541-535-6239"
}
],
"practiceLocations": [
{
"address_1": "400 W Hersey St Ste 4",
"address_purpose": "LOCATION",
"city": "Ashland",
"state": "OR",
"postal_code": "975201854",
"country_code": "US",
"telephone_number": "541-631-9446",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1307 W Main St",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "975012936",
"country_code": "US",
"telephone_number": "541-535-6239",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3617 S Pacific Hwy",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "975018957",
"country_code": "US",
"telephone_number": "541-535-6239",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "730 Biddle Rd",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "975046116",
"country_code": "US",
"telephone_number": "541-535-6239",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4940 Hamrick Rd",
"address_purpose": "LOCATION",
"city": "Central Point",
"state": "OR",
"postal_code": "975023072",
"country_code": "US",
"telephone_number": "541-535-6239",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "910 S Central Ave",
"address_purpose": "LOCATION",
"city": "Medford",
"state": "OR",
"postal_code": "975017854",
"country_code": "US",
"telephone_number": "541-535-6239",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANCUSO",
"first_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2022-07-21",
"last_updated": "2024-04-09",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.