NPIMap

Individual provider Active NPI

Myrna Ann Phillips, LMFT

  • Marriage & Family Therapist
  • Salem, OR
National Provider Identifier
1508993932
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T0097 Issued in OR
Practice address
565 Union NE
Suite 100 Salem Pastoral Counseling Center
Salem, OR 97301
Phone
(503) 370-8050
Fax
(503) 370-9982
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T0097 OR Primary

Addresses

Primary practice location

565 Union NE
Suite 100 Salem Pastoral Counseling Center
Salem, OR 97301

Mailing address

565 Union NE
Suite 100 Salem Pastoral Counseling Center
Salem, OR 97301
Phone (503) 370-8050

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
T0097ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Pastoral Counseling Center Marriage & Family Therapist Past Accepting new patients

Organizations & group practices 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508993932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 UNION NE",
            "address_2": "SUITE 100 SALEM PASTORAL COUNSELING CENTER",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-370-8050",
            "fax_number": "503-370-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 UNION NE",
            "address_2": "SUITE 100 SALEM PASTORAL COUNSELING CENTER",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97301",
            "telephone_number": "503-370-8050",
            "fax_number": "503-370-9982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MYRNA",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.