NPIMap

Organization Active NPI

Exodus Recovery Services LLC.

  • Addiction (Substance Use Disorder) Counselor
  • Harrisburg, OR
National Provider Identifier
1669092201
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
EXODUS RECOVERY SERVICES LLC.
Practice address
230 N 3Rd St Ste 105
Harrisburg, OR 97446-9679
Phone
(541) 998-5660
Fax
(541) 998-5678
NPI assigned
Apr 23, 2020
Organization subpart
Yes
Parent organization
EXODUS RECOVERY SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Authorized official

Name
Elizabeth Merritt, QMHP-R, CADCIIINPI 1669897427
Title
Executive Director
Phone
(541) 952-1719

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

230 N 3Rd St Ste 105
Harrisburg, OR 97446-9679

Mailing address

230 N 3Rd St Ste 105
Harrisburg, OR 97446-9679
Phone (541) 998-5660

Other practice location 1

230 N 3rd St Ste 105
Harrisburg, OR 97446-9679
Phone (541) 998-5660

Other names 1

  • Exodus Behavioral Health Services Doing business as

National Provider Directory

National Provider Directory
Part of
Exodus Recovery Services LLC

Locations

230 N 3rd St
Ste 105
Harrisburg, OR 97446
Phone (541) 998-5660

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1669092201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N 3RD ST STE 105",
            "city": "HARRISBURG",
            "state": "OR",
            "postal_code": "974469679",
            "telephone_number": "541-998-5660",
            "fax_number": "541-998-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N 3RD ST STE 105",
            "city": "HARRISBURG",
            "state": "OR",
            "postal_code": "974469679",
            "telephone_number": "541-998-5660",
            "fax_number": "541-998-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 N 3rd St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "OR",
            "postal_code": "974469679",
            "country_code": "US",
            "telephone_number": "541-998-5660",
            "fax_number": "541-998-5678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXODUS RECOVERY SERVICES LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXODUS RECOVERY SERVICES LLC",
        "enumeration_date": "2020-04-23",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "MERRITT",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "541-952-1719",
        "authorized_official_credential": "QMHP-R, CADCIII"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Exodus Behavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrisburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.