Stephen Pethick, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1569 Issued in OR

Practice address

401 E 10TH Ave
Suite 530
Eugene, OR 97401-3367

Phone

(541) 687-7787

Fax

(855) 646-7433

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Steve Pethick, PHD PC

  • Community/Behavioral Health Agency
  • Eugene, OR
  • NPI 1013322411
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1356404172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3163",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974030163",
            "telephone_number": "541-687-7787",
            "fax_number": "855-646-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 10TH AVE",
            "address_2": "SUITE 530",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013367",
            "telephone_number": "541-687-7787",
            "fax_number": "855-646-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETHICK",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OMAP",
            "identifier": "298598",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrice Anne Peterson, LAC
• Ralph G Peterson, PA
• Regan Peterson, RD, LD
• Thomas David Peterson, M.D.
• Heather Marie Petet
• Natasa Petrac, M.D.
• Kara Lynn Petredis, PMHNP
• Meaghan Petrunic
• Tiffany Rose Petry, LAC
• Patricia Rose Pettit-Blair

• Clinical Psychologist in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.