Active NPI
Sarah May Eilertson, LPC, MS, NCC, CCTP
- Mental Health Counselor
- Medford, OR
National Provider Identifier
1972978336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C4352
- Practice address
- 810 E Jackson St
Medford, OR 97504-6773 - Phone
- (541) 500-7111
- Fax
- (541) 507-9118
- NPI assigned
- Dec 9, 2015
- Sex
- Female
- Sole proprietor
- No
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 | C4352 | OR | Primary |
Addresses
Primary practice location
810 E Jackson St
Medford, OR 97504-6773
Mailing address
810 E Jackson St
Medford, OR 97504-6773
Phone (541) 500-7111
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C4352 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711411200000",
"number": "1972978336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 E JACKSON ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046773",
"telephone_number": "541-500-7111",
"fax_number": "541-507-9118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "810 E JACKSON ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975046773",
"telephone_number": "541-500-7111",
"fax_number": "541-507-9118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EILERTSON",
"first_name": "SARAH",
"middle_name": "MAY",
"credential": "LPC, MS, NCC, CCTP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-09",
"last_updated": "2024-03-26",
"certification_date": "2024-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C4352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.