Active NPI
Connee Lea Peters Reau, LPC
- Counselor
- Salem, OR
National Provider Identifier
1699893891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C0340
- Practice address
- 965 Liberty Street SE
Salem, OR 97302 - Phone
- (503) 588-2004
- Fax
- (503) 588-2415
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | C0340 | OR | Primary |
Addresses
Primary practice location
965 Liberty Street SE
Salem, OR 97302
Mailing address
9003 Jackson Hill Rd SE
Salem, OR 97306
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042577 | Medicaid | OR |
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 |
|---|---|---|---|
| C0340 | OR | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Polk Yamhill & Marion Child Treatment Services Inc | Counselor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counselor
- Salem, OR
- NPI 1760685176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699893891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9003 JACKSON HILL RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "97306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "965 LIBERTY STREET SE",
"city": "SALEM",
"state": "OR",
"postal_code": "97302",
"telephone_number": "503-588-2004",
"fax_number": "503-588-2415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERS REAU",
"first_name": "CONNEE",
"middle_name": "LEA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "C0340",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "042577",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, 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.