Active NPI
Jeff Dane Christensen, M.A.
- Marriage & Family Therapist
- Roseburg, OR
National Provider Identifier
1629308820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 20868
- Practice address
- 5583 Sunshine Rd
Roseburg, OR 97470-9458 - Phone
- (541) 672-4055
- NPI assigned
- Jan 11, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | T1045 | OR | |
| Marriage & Family Therapist | 106H00000X | 20868 | CA | Primary |
Addresses
Primary practice location
5583 Sunshine Rd
Roseburg, OR 97470-9458
Mailing address
5583 Sunshine Rd
Roseburg, OR 97470-9458
Phone (541) 672-4055
Other names 1
- Jeff Dane Christensen
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T1045 | OR | MD | Professional Counselor |
| 20868 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1629308820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5583 SUNSHINE RD",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974709458",
"telephone_number": "541-672-4055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5583 SUNSHINE RD",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974709458",
"telephone_number": "541-672-4055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTENSEN",
"first_name": "JEFF",
"middle_name": "DANE",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-01-11",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "T1045",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "20868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEFF",
"last_name": "CHRISTENSEN",
"middle_name": "DANE",
"credential": "M.A.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.