Jackson County Mental Health

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

JACKSON COUNTY MENTAL HEALTH

Practice address

1911 Hazel Ave
Medford, OR 97501-1630

Phone

(541) 734-3953

NPI assigned

Dec 27, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Gordon A Norman, LPC

Title

Program Manager

Phone

(541) 734-3952

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1780988253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 HAZEL AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975011630",
            "telephone_number": "541-734-3953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 HAZEL AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975011630",
            "telephone_number": "541-734-3953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON COUNTY MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "NORMAN",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "541-734-3952",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Jacks, MD
• Jackson Co Child Abuse Task Force Inc
• Jackson County Child Abuse Task Force Inc
• Jackson County Community Justice
• Jackson County HHS
• Jackson County Mental Health
• Jackson County Oregon
• Jackson County Physical Therapy LLP
• Steven Lee Jackson-Villegas
• Brian A Jackson, CADC I

• All providers in Medford, OR
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.