Individual provider Active NPI

Elizabeth Reyes, LMFT

  • Marriage & Family Therapist
  • Eugene, OR
National Provider Identifier
1629485560
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
T1363 Issued in OR
Practice address
243 W 10TH Ave
Eugene, OR 97401-3008
Phone
(541) 279-2245
Fax
(541) 804-7380
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X T1363 OR Primary

Addresses

Primary practice location

243 W 10TH Ave
Eugene, OR 97401-3008

Mailing address

243 W 10TH Ave
Eugene, OR 97401-3008
Phone (541) 279-2245

Other practice location 1

20 E 13th Ave
Eugene, OR 97401-3535
Phone (541) 345-7605

Other practice location 2

1200 Hilyard St Ste 540
Eugene, OR 97401-8122
Phone (458) 205-7070

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
T1363ORMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Therapy LLC Marriage & Family Therapist CurrentSince Aug 23, 2020 Accepting new patients

Locations

1245 Pearl St
Ste 208
Eugene, OR 97401
Phone (541) 279-2245

243 W 10th Ave
Eugene, OR 97401
Phone (541) 279-2245

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": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1629485560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 W 10TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013008",
            "telephone_number": "541-279-2245",
            "fax_number": "541-804-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 W 10TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013008",
            "telephone_number": "541-279-2245",
            "fax_number": "541-804-7380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 E 13th Ave",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974013535",
            "country_code": "US",
            "telephone_number": "541-345-7605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 Hilyard St Ste 540",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974018122",
            "country_code": "US",
            "telephone_number": "458-205-7070",
            "fax_number": "458-205-7089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.