Melissa Marie Gomsrud, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C1466 Issued in OR

Practice address

1034 Lawrence St
Eugene, OR 97401-3440

Phone

(541) 222-9724

NPI assigned

Nov 22, 2011

Last updated

Aug 15, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Melissa Marie Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: melissagomsrud@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Mental Health

  NPD

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1316214174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 33RD AVE UNIT 51441",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974056623",
            "telephone_number": "541-222-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 LAWRENCE ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013440",
            "telephone_number": "541-222-9724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMSRUD",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-22",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "SMITH",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keith David Goldstein, M.D.
• Lindsey Goldstein
• Caren Amy Golian, LPC
• Trinadad Gomez, L.C.S.W.
• Yolanda Gomez
• Ivan Gonzales
• Mariana Isabella Gonzales, RN
• Pedro Gonzalez Jr Jr.
• Angela Gonzalez
• Laura Elizabeth Gonzalez, LMT

• Mental Health Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; 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.