Active NPI
Therese Pekala, LCSW
- Mental Health Counselor
- Eugene, OR
National Provider Identifier
1700410040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 14914
- Practice address
- 1720 W 25TH Ave
Eugene, OR 97405-1663 - Phone
- (541) 343-9706
- NPI assigned
- Feb 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14914 | CA | Primary |
Addresses
Primary practice location
1720 W 25TH Ave
Eugene, OR 97405-1663
Mailing address
39 Rockridge Dr
Eugene, OR 97405-3581
Phone (541) 799-7949
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 |
|---|---|---|---|
| 14914 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1700410040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "39 ROCKRIDGE DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974053581",
"telephone_number": "541-799-7949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 W 25TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974051663",
"telephone_number": "541-343-9706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEKALA",
"first_name": "THERESE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-25",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "14914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.