South Valley Therapy, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SOUTH VALLEY THERAPY, LLC

Practice address

1991 Garden Ave
Eugene, OR 97403-1934

Phone

(541) 525-1010

NPI assigned

Sep 28, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Davide J Costley, LPC

Title

Owner

Phone

(541) 525-1010

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Davide J. Costley Doing business as

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1841807484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5649 E ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974785417",
            "telephone_number": "541-525-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 GARDEN AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974031934",
            "telephone_number": "541-525-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH VALLEY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "COSTLEY",
        "authorized_official_first_name": "DAVIDE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-525-1010",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500662974",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davide J. Costley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrea Soto, MSW
• Ericka Lee Souders, PH.D., L.P.C.
• South Eugene Dental
• South Eugene Surgi-Center, LLC
• South Hills PT Clinic
• Joshua Travis South I
• Southside Psychology Services PC
• Jamie Souza, AMFT
• Alanna Larea Sowles
• Cassandra Elizabeth Spangler

• Professional Counselor in Eugene, OR
• Providers in Eugene, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.