Amanda M Black

Individual provider Active NPI Mental Health Counselor · Eugene, OR

NPI 1487201851 · NPPES record last updated Aug 21, 2019

Key facts

NPI
1487201851
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
499 W 4TH Ave
Eugene, OR 97401-2505
Phone
(541) 505-5188
NPI assigned
Aug 21, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

499 W 4TH Ave
Eugene, OR 97401-2505

Mailing address

1770 W 13TH Ave
Eugene, OR 97402-3721
Phone (541) 232-8626

Other providers in Eugene, OR

All providers in Eugene, OR · Mental Health Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.