NPIMap

Organization Active NPI

Sheltercare

  • Mental Health Counselor
  • Eugene, OR
National Provider Identifier
1376690107
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SHELTERCARE
Practice address
499 W 4TH Ave
Eugene, OR 97401-2505
Phone
(541) 686-1262
Fax
(541) 686-0359
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Ms. Karen Etter
Title
Controller
Phone
(541) 686-1262

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

499 W 4TH Ave
Eugene, OR 97401-2505

Mailing address

499 W 4TH Ave
Eugene, OR 97401-2505
Phone (541) 686-1262

Other identifiers 3

IdentifierTypeStateIssuer
509446MedicaidOR
509352MedicaidOR
223701MedicaidOR

Other names 1

  • Lane ShelterCare Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Heeran Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1376690107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "499 W 4TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012505",
            "telephone_number": "541-686-1262",
            "fax_number": "541-686-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 W 4TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012505",
            "telephone_number": "541-686-1262",
            "fax_number": "541-686-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTERCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "ETTER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "541-686-1262",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509446",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509352",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223701",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lane ShelterCare",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.