Paul Michael Emmons, PEER SUPPORT
Individual provider Active NPI Peer Specialist · Pendleton, OR
NPI 1962183293 · NPPES record last updated May 7, 2024
Key facts
- NPI
- 1962183293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 39 SE Court Ave Ste 202
Pendleton, OR 97801-2228 - Phone
- (541) 862-4357
- NPI assigned
- Jul 28, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stonewall Behavioral Health | Current | Accepting new patients | |
| Bright Path, Inc. | Peer Specialist | Current |
Accepting new patients |
| Community Counseling Solutions | Past |
Accepting new patients | |
| Community Counseling Solutions | Past |
Accepting new patients |
Locations
39 SE Court Ave
Ste 202
Pendleton, OR 97801
Phone (541) 862-4357
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
39 SE Court Ave Ste 202
Pendleton, OR 97801-2228
Mailing address
PO Box 469
Heppner, OR 97836-0469
Phone (541) 676-9161
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396592663 | Medicaid | OR |
Other providers in Pendleton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.