Active NPI
Jena R Moore, LMFT
- Marriage & Family Therapist
- Eugene, OR
National Provider Identifier
1417370792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T1610
- Practice address
- 240 Country Club Rd Ste B
Eugene, OR 97401-2479 - Phone
- (541) 343-7200
- Fax
- (844) 364-4271
- NPI assigned
- Jan 22, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | T1610 | OR | Primary |
Addresses
Primary practice location
240 Country Club Rd Ste B
Eugene, OR 97401-2479
Mailing address
1574 Coburg Rd PMB 956
Eugene, OR 97401
Phone (541) 343-7200
Other practice location 1
1170 Pearl St
Eugene, OR 97401-3541
Phone (541) 743-4340
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T1610 | OR | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champion Family Therapy, LLC | Mental Health | Past | Accepting new patients |
| Oslc Community Programs | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Eugene, OR
- NPI 1295747186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1417370792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1574 COBURG RD PMB 956",
"city": "EUGENE",
"state": "OR",
"postal_code": "97401",
"telephone_number": "541-343-7200",
"fax_number": "844-364-4271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 COUNTRY CLUB RD STE B",
"city": "EUGENE",
"state": "OR",
"postal_code": "974012479",
"telephone_number": "541-343-7200",
"fax_number": "844-364-4271"
}
],
"practiceLocations": [
{
"address_1": "1170 Pearl St",
"address_purpose": "LOCATION",
"city": "Eugene",
"state": "OR",
"postal_code": "974013541",
"country_code": "US",
"telephone_number": "541-743-4340",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "JENA",
"middle_name": "R",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-22",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T1610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.