Jeannine Deniece Deaville

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

4909 S Coast Hwy Ste 1
South Beach, OR 97366-9667

Phone

(541) 574-5960

Fax

(541) 265-0601

NPI assigned

Aug 11, 2014

Last updated

Aug 11, 2014By the provider in NPPES

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

• Jeannine Deniece Marshall Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Lincoln

  dba Lincoln County Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newport, OR
  • NPI 1740061878
  NPD (past)

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1952710352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SW NYE ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653821",
            "telephone_number": "541-265-0581",
            "fax_number": "541-574-6252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 S COAST HWY STE 1",
            "city": "SOUTH BEACH",
            "state": "OR",
            "postal_code": "973669667",
            "telephone_number": "541-574-5960",
            "fax_number": "541-265-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAVILLE",
        "first_name": "JEANNINE",
        "middle_name": "DENIECE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-11",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNINE",
            "last_name": "MARSHALL",
            "middle_name": "DENIECE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Claire Alexander
• Dennis Dewitt Buckmaster, M.S
• Stacey Lynn Butterfield, RN
• Dianne M Conklin
• Amy Coppa, LCSW
• Terri J Douglass
• William Joseph Driscoll, LCSW
• Stephanie Marie Earls, RN
• Harney Medical Supplies Inc.
• Linnea Harper, L.C.S.W.

• Counselor in South Beach, OR
• Providers in South Beach, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.