Individual provider Active NPI

Marc Rosewood

  • Addiction (Substance Use Disorder) Counselor
  • Medford, OR
National Provider Identifier
1770981987
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
140 S Holly St
Medford, OR 97501-3113
Phone
(541) 774-8201
Fax
(541) 774-7979
NPI assigned
Dec 22, 2014
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

140 S Holly St
Medford, OR 97501-3113

Mailing address

140 S Holly St
Medford, OR 97501-3113
Phone (541) 774-8201

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250901000592 OR Practitioner - Mental Health Counselor 6901307842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

11740 SW 68TH Pkwy
Suite 200
Tigard, OR 97223-9058
Phone (971) 352-6984

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Mental Health CurrentSince Jun 30, 2025 Accepting new patients

Locations

5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100

11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1770981987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S HOLLY ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013113",
            "telephone_number": "541-774-8201",
            "fax_number": "541-774-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S HOLLY ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013113",
            "telephone_number": "541-774-8201",
            "fax_number": "541-774-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEWOOD",
        "first_name": "MARC",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-22",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.