Individual provider Active NPI

William Dusenberry, LPC

  • Mental Health Counselor
  • Eugene, OR
National Provider Identifier
1487088993
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C5300 Issued in OR
Practice address
1258 High St
Eugene, OR 97401-3238
Phone
(541) 342-8437
Fax
(485) 201-7150
NPI assigned
Sep 3, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C5300 OR Primary

Addresses

Primary practice location

1258 High St
Eugene, OR 97401-3238

Mailing address

1258 High St
Eugene, OR 97401-3238
Phone (541) 342-8437

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

LicenseStateTypeSpecialty
C5300ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Collective Elements Psychotherapy LLC Mental Health Current Accepting new patients
Center for Family Development, Inc. Mental Health Past Accepting new patients
Center for Family Development, Inc. Past Accepting new patients

Locations

440 E Broadway
Ste 100
Eugene, OR 97401
Phone (541) 712-3011

Interoperability endpoints

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

Organizations & group practices 3

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1487088993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 HIGH ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013238",
            "telephone_number": "541-342-8437",
            "fax_number": "458-201-7150"
        },
        {
            "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": "485-201-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUSENBERRY",
        "first_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5300",
            "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 May 15, 2019; 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.