Ambyr Rose Stores, MSW, LCSW, QMHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L10359 Issued in OR

Practice address

1599 Oak St
Eugene, OR 97401-4008

Phone

(541) 255-1411

Fax

(541) 255-1412

NPI assigned

Jan 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beautiful Minds PC

  • Psychiatric/Mental Health Nurse Practitioner
  • Eugene, OR
  • NPI 1336809847
  Medicare reassignment NPD
• Applegate Counseling LLC

  • Counselor
  • Eugene, OR
  • NPI 1023625191
  Medicare reassignment

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1730545211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 WILLAMETTE ST # 140",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014049",
            "telephone_number": "541-255-1411",
            "fax_number": "541-255-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 OAK ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974014008",
            "telephone_number": "541-255-1411",
            "fax_number": "541-255-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORES",
        "first_name": "AMBYR",
        "middle_name": "ROSE",
        "credential": "MSW, LCSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "A4910",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730545211",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin J Stone
• Jenelle M'Lou Braun Stone, MA, MS, MS, PH.D. -
• Nicole Marie Stone
• Shannon Dae Stone
• Suzanne V Stone
• Abigail Rose Storm
• Hayley Marie Storms, LMT
• Deborah Karin Stotler, MA, LMFT, CADC III
• Jonathan Bruce Stout, M.D,
• Carol J Stoutland, D.C.

• Clinical Social Worker in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.