Pheobe Ellen Mae, M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A2943 Issued in OR

Practice address

1170 Pearl St
Eugene, OR 97401-3541

Phone

(541) 743-4340

Fax

(541) 743-4369

NPI assigned

Feb 15, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Pheobe Maxine Kent Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Aug 23, 2023 through Aug 23, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Madrone Mental Health Services, LLC

  • Clinical Social Worker
  • Eugene, OR
  • NPI 1124400908
  NPD (past)
• Oslc Community Programs

  • Adolescent and Children Mental Health Clinic/Center
  • Eugene, OR
  • NPI 1295747186
  NPD (past)

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1477826808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 PEARL ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013541",
            "telephone_number": "541-743-4340",
            "fax_number": "541-743-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 PEARL ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013541",
            "telephone_number": "541-743-4340",
            "fax_number": "541-743-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAE",
        "first_name": "PHEOBE",
        "middle_name": "ELLEN",
        "credential": "M.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A2943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHEOBE",
            "last_name": "KENT",
            "middle_name": "MAXINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Claire Orion Silverman Madhavan
• James W Madras, LMT
• Diane Elizabeth Madrigale, MA, LPC, NCC
• Madrone Mental Health Services, LLC
• Christine Charlotte Madzik, RD, LD
• Christina Love Maeder, L.C.S.W.
• Christy Mafoti
• Ramona Elizabeth Magambo, PHARMD
• Sean Jacob Magill, DPT
• Dana J Maginnis

• Clinical Social Worker in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.