Jose Eduardo Carrillo, M.A., QMHP

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

420 NE 5TH St
McMinnville, OR 97128-4603

Phone

(503) 434-7462

NPI assigned

Aug 30, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504051200000",
    "number": "1669990503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 CARSON LOOP",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971161632",
            "telephone_number": "408-206-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 NE 5TH ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284603",
            "telephone_number": "503-434-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "JOSE",
        "middle_name": "EDUARDO",
        "name_prefix": "Mr.",
        "credential": "M.A., QMHP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ricardo Carlon, M.D.
• Andrew Carlson
• Tara Carlson, RN
• Taylor Carlstrom, MSW
• Mary Margrett Carpio
• Kelly William Carsh
• Patti Carter
• Anna Marie Carvajal, MSW
• Kay Esther Case, MD
• Leanne Therese Case

• Mental Health Counselor in McMinnville, OR
• Providers in McMinnville, 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 Aug 30, 2017; 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.