Mary's River Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

MARY'S RIVER COUNSELING, LLC

Practice address

2364 Main St
BLDG a
Philomath, OR 97370-9488

Phone

(541) 708-0937

NPI assigned

Oct 26, 2015

Last updated

Oct 26, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicolaus Goebeler

Title

Manager

Phone

(541) 708-0937

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1801268180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2364 MAIN ST",
            "address_2": "BLDG A",
            "city": "PHILOMATH",
            "state": "OR",
            "postal_code": "973709488",
            "telephone_number": "541-708-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2364 MAIN ST",
            "address_2": "BLDG A",
            "city": "PHILOMATH",
            "state": "OR",
            "postal_code": "973709488",
            "telephone_number": "541-708-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY'S RIVER COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "GOEBELER",
        "authorized_official_first_name": "NICOLAUS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "541-708-0937"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Philomath, OR
• Providers in Philomath, OR by specialty
• Community/Behavioral Health Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.