Active NPI
Annelise P Heitman, LMFT
- Marriage & Family Therapist
- Eugene, OR
National Provider Identifier
1508173360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T0723
- Practice address
- 401 E 10TH Ave
Suite 330
Eugene, OR 97401-3317 - Phone
- (541) 868-2004
- NPI assigned
- Aug 31, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | T0723 | OR | Primary |
Addresses
Primary practice location
401 E 10TH Ave
Suite 330
Eugene, OR 97401-3317
Mailing address
1672 Wilson CT
Eugene, OR 97402-3361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 16, 2024 through Dec 16, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T0723 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283212800000",
"number": "1508173360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1672 WILSON CT",
"city": "EUGENE",
"state": "OR",
"postal_code": "974023361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E 10TH AVE",
"address_2": "SUITE 330",
"city": "EUGENE",
"state": "OR",
"postal_code": "974013317",
"telephone_number": "541-868-2004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEITMAN",
"first_name": "ANNELISE",
"middle_name": "P",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-31",
"last_updated": "2010-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T0723",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
- Jennifer Anne Heideman, LMT
- Heidi C. Schelling, PHD, Licsw, Psychotherapy Services, LLC (Heidi C Schelling Phd LICSW)
- Bradley Vincent Heimann, B.A., B.S.
- Christina M Heinrich, PHARM.D.
- Eden Keats Heinzke
- Michelle Kay Heitman, LMT
- Michael Hejazi
- Anna Carolyn Hejinian, MD
- Helen K. Lester D.D.S., PC
- Helen M Coble PHD PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.