Mary E Aguilera, PH.D. – Professional Counselor

Key facts

NPI: 1740595255
Entity type: Individual (NPI type 1)
Primary specialty: Professional Counselor 101YP2500X
License: C1963 (OR)
Practice address: 602 SW Madison Ave
Corvallis, OR 97333-4515
Phone: (541) 753-9217
NPI assigned: Aug 10, 2010
Sex: Female
Sole proprietor: No

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.

Pastoral Counseling Center of the Mid Willamette Valley Community/Behavioral Health Agency · Corvallis, OR · NPI 1104964949

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Doctor of Philosophy

State licenses

License	State	Type	Specialty
C1963	OR	MD	Professional Counselor

Practice roles

Organization	Specialty	Status	New patients
Pastoral Counseling Center of the Mid Willamette Valley		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Professional Counselor	101YP2500X	C1963	OR	Yes

Addresses

Primary practice location

602 SW Madison Ave
Corvallis, OR 97333-4515

Mailing address

PO Box 1196
Philomath, OR 97370-1196
Phone (541) 602-5703

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 10, 2010.

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1740595255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1196",
            "city": "PHILOMATH",
            "state": "OR",
            "postal_code": "973701196",
            "telephone_number": "541-602-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 SW MADISON AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973334515",
            "telephone_number": "541-753-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUILERA",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C1963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corvallis, OR

All providers in Corvallis, OR · Professional Counselor in Oregon

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.