Individual provider Active NPI

Ellie Klopp, QMHP

  • Mental Health Counselor
  • Cottage Grove, OR
National Provider Identifier
1326107756
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
410 N 9TH St
Cottage Grove, OR 97424-1307
Phone
(541) 942-2850
Fax
(541) 942-1574
NPI assigned
Dec 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

410 N 9TH St
Cottage Grove, OR 97424-1307

Mailing address

410 N 9TH St
Cottage Grove, OR 97424-1307
Phone (541) 942-2850

Other identifiers 1

IdentifierTypeStateIssuer
019047MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221002481 OR Practitioner - Mental Health Counselor 5698119378 Practice locations: Eugene, OR

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

372 W 12TH Ave
Suite 2
Eugene, OR 97401-3493
Phone (541) 556-9306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1326107756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N 9TH ST",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241307",
            "telephone_number": "541-942-2850",
            "fax_number": "541-942-1574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N 9TH ST",
            "city": "COTTAGE GROVE",
            "state": "OR",
            "postal_code": "974241307",
            "telephone_number": "541-942-2850",
            "fax_number": "541-942-1574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOPP",
        "first_name": "ELLIE",
        "name_prefix": "Ms.",
        "credential": "QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019047",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottage Grove, OR

Sources for this page

Verify at the official NPI Registry.