Individual provider Active NPI

Robyn L Herrick

  • Mental Health Counselor
  • Tillamook, OR
National Provider Identifier
1871622480
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C2355 Issued in OR
Practice address
906 Main Ave
Tillamook, OR 97141-3816
Phone
(503) 842-8201
Fax
(503) 815-1870
NPI assigned
Mar 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C2355 OR
Mental Health Counselor 101YM0800X C2355 OR Primary

Addresses

Primary practice location

906 Main Ave
Tillamook, OR 97141-3816

Mailing address

2645 Portland Rd NE
Salem, OR 97301-0198

Other practice location 1

2645 Portland Rd NE
Salem, OR 97301-0198
Phone (503) 390-5637

Other identifiers 1

IdentifierTypeStateIssuer
197749MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240828001405 OR Practitioner - Mental Health Counselor 8123567674 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C2355ORMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Options Counseling Services of Oregon Mental Health CurrentSince Jun 15, 2024 Accepting new patients
Tillamook Family Counseling Center Past Accepting new patients
Tillamook Family Counseling Center PastSince Mar 5, 2016 Accepting new patients

Locations

360 E 10th Ave
Ste 450
Eugene, OR 97401

11010 SE Division St
Ste 202
Portland, OR 97266
Phone (503) 335-5975

2645 Portland Rd NE
Ste 120
Salem, OR 97301

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/tfcc/r4/

Organizations & group practices 3

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1871622480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 PORTLAND RD NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973010198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "971413816",
            "telephone_number": "503-842-8201",
            "fax_number": "503-815-1870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2645 Portland Rd NE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973010198",
            "country_code": "US",
            "telephone_number": "503-390-5637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERRICK",
        "first_name": "ROBYN",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "C2355",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197749",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tillamook, OR

Sources for this page

Verify at the official NPI Registry.