Autumn Melody Whaley, BS, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3891 Issued in OR

Practice address

1750 Nebraska Ave
Grants Pass, OR 97527-5700

Phone

(541) 474-5579

Fax

(541) 474-5842

NPI assigned

Oct 3, 2010

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 names 1

• Mrs. Autumn Melody Whaley Brown Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Master of Arts

State licenses

Practice roles

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.

• Kairos Northwest

  dba Kairos

  • Community/Behavioral Health Agency
  • Grants Pass, OR
  • NPI 1487782900
  NPD (past)

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

{
    "created_epoch": "1286064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1912216326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 NEBRASKA AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275700",
            "telephone_number": "541-474-5579",
            "fax_number": "541-474-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 NEBRASKA AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975275700",
            "telephone_number": "541-474-5579",
            "fax_number": "541-474-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "AUTUMN",
        "middle_name": "MELODY",
        "name_prefix": "Ms.",
        "credential": "BS, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-03",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "BROWN",
            "middle_name": "MELODY WHALEY",
            "prefix": "MRS.",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• William Thomas West
• Dawn Westling
• Haylie Marie Weston, RPH, PHARM.D.
• Lisa Michelle Weston, R.N., BSN
• Peter Weston II, QMHA
• Lana Whinery, LPN
• Elayna Darlene Whisenant
• White City Vamc
• Abigail White, LMT
• Tanya White

• Professional Counselor in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.