NPIMap

Organization Active NPI

Motivational Parent

  • Clinical Psychologist
  • Roseburg, OR
National Provider Identifier
1316608441
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MOTIVATIONAL PARENT
Practice address
50 Carmel CT
Roseburg, OR 97471-4606
Phone
(541) 900-8244
NPI assigned
Dec 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Authorized official

Name
Jason Wilcox, LCSWNPI 1225280753
Title
Director
Phone
(541) 900-8244

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Voluntary or Charitable Agency 251V00000X

Addresses

Primary practice location

50 Carmel CT
Roseburg, OR 97471-4606

Mailing address

1414 NW Valley View Dr # 107
Roseburg, OR 97471-1760
Phone (541) 900-8244

National Provider Directory

National Provider Directory

Locations

1414 NW Valley View Dr
Roseburg, OR 97471
Phone (541) 900-8244

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": "1640822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640822400000",
    "number": "1316608441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 NW VALLEY VIEW DR # 107",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711760",
            "telephone_number": "541-900-8244",
            "fax_number": "541-524-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CARMEL CT",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974714606",
            "telephone_number": "541-900-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTIVATIONAL PARENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-30",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "541-900-8244",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Dec 30, 2021; 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.