Active NPI
Denise Childs, LPC
- Mental Health Counselor
- Salem, OR
National Provider Identifier
1932452927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C2963
- Practice address
- 1645 Liberty St SE
Suite 3
Salem, OR 97302-4347 - Phone
- (503) 784-6232
- NPI assigned
- Oct 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C2963 | OR | Primary |
Addresses
Primary practice location
1645 Liberty St SE
Suite 3
Salem, OR 97302-4347
Mailing address
1645 Liberty St SE
Suite 3
Salem, OR 97302-4347
Phone (503) 784-6232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500686699 | Medicaid | OR |
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
| License | State | Type | Specialty |
|---|---|---|---|
| C2963 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475712000000",
"number": "1932452927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1645 LIBERTY ST SE",
"address_2": "SUITE 3",
"city": "SALEM",
"state": "OR",
"postal_code": "973024347",
"telephone_number": "503-784-6232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1645 LIBERTY ST SE",
"address_2": "SUITE 3",
"city": "SALEM",
"state": "OR",
"postal_code": "973024347",
"telephone_number": "503-784-6232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDS",
"first_name": "DENISE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-16",
"last_updated": "2016-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C2963",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500686699",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.