Individual provider Active NPI

Casey Romine

  • Mental Health Counselor
  • Terrebonne, OR
National Provider Identifier
1295223923
Registry record updated Feb 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C6145 Issued in OR
Practice address
16232 SW Lower Bridge Way
Terrebonne, OR 97760-9678
Phone
(541) 316-0206
NPI assigned
Apr 27, 2018
Last updated
Feb 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X C6145 OR Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

16232 SW Lower Bridge Way
Terrebonne, OR 97760-9678

Mailing address

16232 SW Lower Bridge Way
Terrebonne, OR 97760-9678
Phone (541) 410-8713

Other identifiers 1

IdentifierTypeStateIssuer
500756496MedicaidOR

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

State licenses

LicenseStateTypeSpecialty
C6145ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Free Spirit Counseling LLC Mental Health CurrentSince Jun 5, 2022 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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1295223923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16232 SW LOWER BRIDGE WAY",
            "city": "TERREBONNE",
            "state": "OR",
            "postal_code": "977609678",
            "telephone_number": "541-410-8713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16232 SW LOWER BRIDGE WAY",
            "city": "TERREBONNE",
            "state": "OR",
            "postal_code": "977609678",
            "telephone_number": "541-316-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMINE",
        "first_name": "CASEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C6145",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500756496",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terrebonne, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.