Active NPI
Mary Jo Wood, LPC
- Professional Counselor
- Tillamook, OR
National Provider Identifier
1639246291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C1313
- Practice address
- 2507 Main Ave N Ste B
Tillamook, OR 97141-9297 - Phone
- (503) 842-1201
- Fax
- (503) 842-0001
- NPI assigned
- Nov 29, 2006
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | C1313 | OR | Primary |
Addresses
Primary practice location
2507 Main Ave N Ste B
Tillamook, OR 97141-9297
Mailing address
2507 Main Ave N Ste B
Tillamook, OR 97141-9297
Phone (503) 842-1201
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
| License | State | Type | Specialty |
|---|---|---|---|
| C1313 | OR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639246291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2507 MAIN AVE N STE B",
"city": "TILLAMOOK",
"state": "OR",
"postal_code": "971419297",
"telephone_number": "503-842-1201",
"fax_number": "503-842-0001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2507 MAIN AVE N STE B",
"city": "TILLAMOOK",
"state": "OR",
"postal_code": "971419297",
"telephone_number": "503-842-1201",
"fax_number": "503-842-0001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "MARY",
"middle_name": "JO",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OR",
"license": "C1313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tillamook, 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.