Individual provider Active NPI

Shaunta Hemingway, CADC III, MAC, LPC

  • Mental Health Counselor
  • Eugene, OR
National Provider Identifier
1851759856
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6278 Issued in OR
Practice address
1170 Garfield St
Eugene, OR 97402-3513
Phone
(541) 972-2802
NPI assigned
Feb 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 6278 OR Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15-08-22U

Addresses

Primary practice location

1170 Garfield St
Eugene, OR 97402-3513

Mailing address

1170 Garfield St
Eugene, OR 97402-3513
Phone (541) 972-2802

Other identifiers 2

IdentifierTypeStateIssuer
50070861MedicaidOR
500708761MedicaidOR

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

LicenseStateTypeSpecialty
6278ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
One Step at a Time Addiction (Substance Use Disorder) CurrentSince Sep 24, 2023 Accepting new patients
Peacehealth Medical Group Mental Health PastSince Aug 1, 2021 Accepting new patients

Locations

1170 Garfield St
Eugene, OR 97402
Phone (541) 972-2802

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1851759856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 GARFIELD ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023513",
            "telephone_number": "541-972-2802",
            "fax_number": "541-972-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 GARFIELD ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974023513",
            "telephone_number": "541-972-2802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMINGWAY",
        "first_name": "SHAUNTA",
        "name_prefix": "Dr.",
        "credential": "CADC III, MAC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "6278",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "15-08-22U",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50070861",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500708761",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.

Verify at the official NPI Registry.