Active NPI
Alicia Pruitt
- Mental Health Counselor
- Salem, OR
National Provider Identifier
1790298099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- L10934
- Practice address
- 2355 State St Ste 101
Salem, OR 97301-4541 - Phone
- (541) 203-3867
- NPI assigned
- Nov 8, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | L10934 | OR | Primary |
Addresses
Primary practice location
2355 State St Ste 101
Salem, OR 97301-4541
Mailing address
1292 High St Unit A3034
Eugene, OR 97401-3238
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L10934 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678752000000",
"number": "1790298099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1292 HIGH ST UNIT A3034",
"city": "EUGENE",
"state": "OR",
"postal_code": "974013238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2355 STATE ST STE 101",
"city": "SALEM",
"state": "OR",
"postal_code": "973014541",
"telephone_number": "541-203-3867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUITT",
"first_name": "ALICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-08",
"last_updated": "2023-03-14",
"certification_date": "2023-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "L10934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
- Providence Health & Services - Oregon (Prov Peds Neurology Salem)
- Providence Health & Services Oregon (Providence Medcial Group)
- Providence Health & Services Oregon (Providence Home Medical Equipment)
- Linda L. Prudhomme, LCSW
- Whitney Pruett, LPN
- Christopher Thomas Prze, MD
- Holly Prze
- PT Northwest LLC
- Michael Puerini, MD
- Michelle Marie Pugh, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.