Individual provider Active NPI

Jacqueline L. Hurst, BE, CADC II

  • Addiction (Substance Use Disorder) Counselor
  • Eugene, OR
National Provider Identifier
1366752974
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1258 High St
Eugene, OR 97401-3238
Phone
(541) 342-8437
Fax
(541) 342-1639
NPI assigned
Oct 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

1258 High St
Eugene, OR 97401-3238

Mailing address

4885 Aster St Apt 180
Springfield, OR 97478-6399
Phone (541) 342-8437

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
I20241127003663 OR Practitioner - Clinical Social Worker 2860927860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peacehealth Medical GroupGroup PAC ID 9032023270, 256 clinicians

Practice addresses (Care Compare)

1200 Hilyard St
Eugene, OR 97401-8122
Phone (458) 205-6011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor or Engineering

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Medical Group CurrentSince Jan 12, 2025 Accepting new patients
Peacehealth Medical Group Counselor CurrentSince Jan 12, 2025 Accepting new patients
Center for Family Development, Inc. Addiction (Substance Use Disorder) Past Accepting new patients
Center for Family Development, Inc. Addiction (Substance Use Disorder) Past Accepting new patients

Locations

1200 Hilyard St
Eugene, OR 97401
Phone (458) 205-7070

4010 Aerial Way
Eugene, OR 97402
Phone (541) 242-8300

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/c-f-d/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1366752974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 ASTER ST APT 180",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786399",
            "telephone_number": "541-342-8437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 HIGH ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-342-8437",
            "fax_number": "541-342-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "JACQUELINE",
        "middle_name": "L.",
        "credential": "BE, CADC II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.