Individual provider Active NPI

Richard Lee Ruddell Jr., MA, LPC

  • Professional Counselor
  • Florence, OR
National Provider Identifier
1912159393
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C3061 Issued in OR
Practice address
1445 8TH St
Florence, OR 97439-9351
Phone
(541) 997-6261
Fax
(541) 997-8606
NPI assigned
Oct 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C3061 OR Primary

Addresses

Primary practice location

1445 8TH St
Florence, OR 97439-9351

Mailing address

PO Box 429
Florence, OR 97439-0015
Phone (541) 997-6261

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
I20240205002529 OR Practitioner - Mental Health Counselor 6901249119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Options Counseling Services of OregonGroup PAC ID 1658674197, 22 clinicians

Practice addresses (Care Compare)

1445 8TH St
Florence, OR 97439-9351
Phone (541) 997-6261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C3061ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Options Counseling Services of Oregon CurrentSince Jan 1, 2024 Accepting new patients
Inner Room Somatic Therapy, LLC Professional Past 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

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": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1912159393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974390015",
            "telephone_number": "541-997-6261",
            "fax_number": "541-997-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 8TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399351",
            "telephone_number": "541-997-6261",
            "fax_number": "541-997-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDDELL",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, OR

Sources for this page

Verify at the official NPI Registry.