NPIMap

Organization Active NPI

KLC Behavioral Health and Wellness LLC

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1780287466
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
KLC BEHAVIORAL HEALTH AND WELLNESS LLC
Practice address
2109 Van Buren St
Eugene, OR 97405-2166
Phone
(541) 797-5300
NPI assigned
Nov 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Authorized official

Name
Kathryn ClementsNPI 1750555249
Title
Owner
Phone
(541) 797-5300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2109 Van Buren St
Eugene, OR 97405-2166

Mailing address

2109 Van Buren St
Eugene, OR 97405-2166

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1780287466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 VAN BUREN ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974052166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 VAN BUREN ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974052166",
            "telephone_number": "541-797-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLC BEHAVIORAL HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-797-5300"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "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 Dec 29, 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.

Verify at the official NPI Registry.