Individual provider Active NPI

Bradley Phillip Cohn, PH.D.

  • Psychologist
  • Eugene, OR
National Provider Identifier
1942417829
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2867 Issued in OR
Practice address
911 Country Club Rd Ste 290
Eugene, OR 97401-1301
Phone
(541) 313-6199
Fax
(541) 576-8977
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X
Psychologist 103T00000X 2867 OR Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

911 Country Club Rd Ste 290
Eugene, OR 97401-1301

Mailing address

911 Country Club Rd Ste 290
Eugene, OR 97401-1301
Phone (541) 313-6199

Other identifiers 1

IdentifierTypeStateIssuer
500662798MedicaidOR

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
I20191004001934 OR Practitioner - Clinical Psychologist 4789915778 Practice locations: Eugene, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

750 Lawrence St
Suite 3
Eugene, OR 97401-2545
Phone (541) 313-6199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2867ORMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Invictus Therapy and Consultation LLC Psychologist CurrentSince Aug 22, 2019 Accepting new patients
Madrone Mental Health Services, LLC Past Accepting new patients

Locations

911 Country Club Rd
Ste 290
Eugene, OR 97401
Phone (541) 313-6199

750 Lawrence St
#3
Eugene, OR 97401
Phone (541) 313-6199

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1942417829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 COUNTRY CLUB RD STE 290",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974011301",
            "telephone_number": "541-313-6199",
            "fax_number": "541-576-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 COUNTRY CLUB RD STE 290",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974011301",
            "telephone_number": "541-313-6199",
            "fax_number": "541-576-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHN",
        "first_name": "BRADLEY",
        "middle_name": "PHILLIP",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2867",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500662798",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.