Jennifer Rachel Fedorov, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T0571 Issued in OR

Practice address

767 Willamette St
Suite301
Eugene, OR 97401-2952

Phone

(541) 232-6680

Fax

(541) 343-2442

NPI assigned

Sep 17, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jennifer Rachel Burt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1659520328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "767 WILLAMETTE ST",
            "address_2": "SUITE 301",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012952",
            "telephone_number": "541-232-6680",
            "fax_number": "541-343-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "767 WILLAMETTE ST",
            "address_2": "SUITE301",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012952",
            "telephone_number": "541-232-6680",
            "fax_number": "541-343-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOROV",
        "first_name": "JENNIFER",
        "middle_name": "RACHEL",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T0571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BURT",
            "middle_name": "RACHEL",
            "prefix": "MS.",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristin Nicole Faus
• Blake V Fausett, M.D
• Amber Lynn Fauteaux, MA
• Camila Fazal
• Shawn Michael Feddersen
• Kristin Gai Fedorov, SA-C
• Madeline Fehlman
• Jason Feinberg
• Toni J Feist, FNP
• Rita Christine Feldmanis-Clever, D.M.D.

• Marriage & Family Therapist in Eugene, OR
• Providers in Eugene, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.