NPIMap

Organization Active NPI

Applegate Psychology & Assoc, LLC

  • Clinical Psychologist
  • Sutherlin, OR
National Provider Identifier
1801067491
Registry record updated Mar 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1309 Issued in OR
Legal business name
APPLEGATE PSYCHOLOGY & ASSOC, LLC
Practice address
1739 Garnet Ave
Sutherlin, OR 97479-9677
Phone
(541) 459-0907
Fax
(541) 459-0907
NPI assigned
Mar 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2008

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

Authorized official

Name
Dr. Cheryl Anne Gifford, PHD
Title
Psychologist/Owner
Phone
(541) 459-0907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 1309 OR Primary

Addresses

Primary practice location

1739 Garnet Ave
Sutherlin, OR 97479-9677

Mailing address

1739 Garnet Ave
Sutherlin, OR 97479-9677
Phone (541) 459-0907

Other identifiers 1

IdentifierTypeStateIssuer
181430MedicaidOR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206057600000",
    "number": "1801067491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 GARNET AVE",
            "city": "SUTHERLIN",
            "state": "OR",
            "postal_code": "974799677",
            "telephone_number": "541-459-0907",
            "fax_number": "541-459-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 GARNET AVE",
            "city": "SUTHERLIN",
            "state": "OR",
            "postal_code": "974799677",
            "telephone_number": "541-459-0907",
            "fax_number": "541-459-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLEGATE PSYCHOLOGY & ASSOC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-21",
        "last_updated": "2008-03-21",
        "status": "A",
        "authorized_official_last_name": "GIFFORD",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "541-459-0907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181430",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sutherlin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2008; 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.