Individual provider Active NPI

Debra Carriere, PHD

  • Psychologist
  • Corvallis, OR
National Provider Identifier
1528105186
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2136 Issued in OR
Practice address
408 SW Monroe Ave
Suite M210F
Corvallis, OR 97333-7210
Phone
(541) 754-0070
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C1275 OR
Psychologist 103T00000X 2136 OR Primary

Addresses

Primary practice location

408 SW Monroe Ave
Suite M210F
Corvallis, OR 97333-7210

Mailing address

408 SW Monroe Ave
Suite 210F
Corvallis, OR 97333-7202
Phone (541) 754-0070

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
C1275ORMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1528105186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 SW MONROE AVE",
            "address_2": "SUITE 210F",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973337202",
            "telephone_number": "541-754-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SW MONROE AVE",
            "address_2": "SUITE M210F",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973337210",
            "telephone_number": "541-754-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIERE",
        "first_name": "DEBRA",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1275",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.