Awaken Freedom, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

AWAKEN FREEDOM, LLC

Practice address

581 W 17TH Ave
Eugene, OR 97401-3816

Phone

(541) 204-2462

NPI assigned

Aug 22, 2019

Organization subpart

No

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

Authorized official

Name

Rebecca Suzanne Perdew, LCSWNPI 1023430774

Title

Owner

Phone

(541) 204-2462

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca Perdew, M.S.W.

  • Mental Health Counselor
  • Eugene, OR
  • NPI 1023430774
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1669029708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 W 17TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013816",
            "telephone_number": "541-204-2462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 W 17TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013816",
            "telephone_number": "541-204-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAKEN FREEDOM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "PERDEW",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-204-2462",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500668772",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.