Amaelo Ezeonwuka, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C8404 Issued in OR

Practice address

1075 Washington St
Eugene, OR 97401-4606

Phone

(541) 321-2278

NPI assigned

Aug 26, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

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.

• Arise Counseling Service, LLC. Dba Northlight Counseling

  • Clinical Social Worker
  • Eugene, OR
  • NPI 1447715834

  Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1447650585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 W 11TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023758",
            "telephone_number": "541-686-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 WASHINGTON ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014606",
            "telephone_number": "541-321-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZEONWUKA",
        "first_name": "AMAELO",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C8404",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shalamar Ewing
• Thomas N Ewing, M.D.
• Excellence Medical Legal Research & Consulting, LLC
• Eyemart Express LLC
• Eyemart Express, LTD.
• Karaine Eziolisa, RN
• Kathy S Faber, FNP
• Takayo Fackrell
• Patrick L Fagan, LCSW
• Patricia Faye Fagundes

• Professional Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.