Active NPI
Jeff R. Cole, PH.D.
- Clinical Psychologist
- Roseburg, OR
National Provider Identifier
1730274010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1332
- Practice address
- 693 NE Stephens Street
Suite a
Roseburg, OR 97470-3166 - Phone
- (541) 643-1375
- Fax
- (541) 464-8700
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1332 | OR | Primary |
Addresses
Primary practice location
693 NE Stephens Street
Suite a
Roseburg, OR 97470-3166
Mailing address
693 NE Stephens St Ste a
Roseburg, OR 97470-3166
Phone (541) 643-1375
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 297201 | 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)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Streamside Counseling Center | 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.
-
- Mental Health Counselor
- Roseburg, OR
- NPI 1255431706
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217808000000",
"number": "1730274010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "693 NE STEPHENS ST STE A",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974703166",
"telephone_number": "541-643-1375",
"fax_number": "541-464-8700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "693 NE STEPHENS STREET",
"address_2": "SUITE A",
"city": "ROSEBURG",
"state": "OR",
"postal_code": "974703166",
"telephone_number": "541-643-1375",
"fax_number": "541-464-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "JEFF",
"middle_name": "R.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2008-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1332",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "297201",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.