Carol Mendoza

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-21-802 Issued in OR

Practice address

1184 McGee CT NE
Keizer, OR 97303-9443

Phone

(503) 304-4358

Fax

(503) 304-4361

NPI assigned

Jul 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1861063174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20674",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973070674",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1184 MCGEE CT NE",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973039443",
            "telephone_number": "503-304-4358",
            "fax_number": "503-304-4361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "465 Commercial St NE # 150",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973013414",
            "country_code": "US",
            "telephone_number": "503-362-2780",
            "fax_number": "503-362-2768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-21-802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO",
            "identifier": "T-21-802",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Collin Maurice McLaughlin, DO
• Bradley Ian McMichael
• Joan Ongat McMichael
• Earl Dean McNabb, DPM
• Joshua M Meador, D.O.
• Mid Valley Family Physicians
• Nayely Maribel Millan
• Melissa Miller
• Sahara Beth Miller, LPC
• Elizabeth Pearl Mills, NURSE PRACTITIONER

• Addiction (Substance Use Disorder) Counselor in Keizer, OR
• Providers in Keizer, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2021; 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.