MR. DAVID J MORTELLARO (NPI# 1306129804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306129804 |
| Entity Type | Individual |
| Full Name | MR. DAVID J MORTELLARO |
| Practice Address |
140 South Holly Street Medford OR 97501 |
| Practice Telephone | 5417748200 |
| Practice Fax Number | 5417747964 |
| Mailing Telephone | 5417748200 |
| Mailing Fax Number | 5417747964 |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2014-12-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851375836 | David L Mortellaro | Counselor | 4656 Brambleton Ave, Roanoke, VA 24018-3437 | 2005-12-02 |
| Street Address |
140 SOUTH HOLLY STREET |
| City | MEDFORD |
| State | OR |
| Zip Code | 97501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407843725 | Luis Felix Oxholm | Psychiatry & Neurology | 140 South Holly Street, Medford, OR 97501 | 2005-10-03 |
| 1508313586 | Kimberli Lanelle Bean | Case Manager/Care Coordinator | 140 South Holly Street, Medford, OR 97501 | 2016-09-07 |
| 1194116640 | Albert Edward Solochier | Registered Nurse | 140 South Holly Street, Medford, OR 97501-3113 | 2015-02-05 |
| 1487051363 | Jamie Marie Barton | Counselor | 140 South Holly Street, Medford, OR 97501 | 2014-11-20 |
| 1063818342 | Caitlin Lawson | Case Manager/Care Coordinator | 140 South Holly Street, Medford, OR 97501 | 2014-11-13 |
| 1316343692 | Sheena Bisera | Case Manager/Care Coordinator | 140 South Holly Street, Medford, OR 97501 | 2014-11-13 |
| 1225434996 | Louisa Saloma | Case Manager/Care Coordinator | 140 South Holly Street, Medford, OR 97501 | 2014-11-07 |
| 1255735098 | Richelle Raelynn Marshall | Case Manager/Care Coordinator | 140 South Holly Street, Medford, OR 97501 | 2014-10-21 |
| 1992109045 | Kevin Hoeper | Case Manager/Care Coordinator | 140 South Holly Street, Medford, OR 97501 | 2014-10-17 |
| 1083018683 | Susan Sherrill | Counselor | 140 South Holly Street, Medford, OR 97501 | 2014-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1669012928 | One of A Kind Therapy LLC | Social Worker | 916 West 10th St #205, Medford, OR 97501 | 2020-01-14 |
| 1265993620 | Star Dialysis LLC | Clinic/Center | 50 Rossanley Dr, Medford, OR 97501 | 2019-03-28 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1316458813 | Rick's Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 562 Parsons Drive, Suite 114, Medford, OR 97501 | 2017-10-24 |
| 1750807111 | La Clinica Del Valle Family Health Care Center Inc. | Clinic/Center | 821 N Riverside Ave, Medford, OR 97501 | 2017-08-17 |
| 1992229009 | Cassandra Schultz | Massage Therapist | 824 East Jackson, Suite A, Medford, OR 97501 | 2017-07-31 |
| 1972962355 | Robin Clevenger | Peer Specialist | 301 S Ivy St, Medford, OR 97501 | 2016-02-15 |
| 1154706984 | Debbie Diane Orr | Behavioral Analyst | 1024 West 9th Street, Medford, OR 97501 | 2015-07-22 |
| Find all providers in zip 97501 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911091 | Araceli Olivares Mciff | Counselor | 201 W 6th St Ste 101, Medford, OR 97501-2708 | 2020-08-04 |
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1326674417 | Jean Yih Kingston | Counselor | Dcs Mental Health Medford, 151 Mystic Avenue, Medford, MA 02155-4632 | 2020-03-20 |
| 1063059228 | Chiron Center Incorporated | Counselor | 2909 N Phoenix Rd, Medford, OR 97504-9490 | 2019-12-06 |
| 1790321784 | Cassandra F Lawrence | Counselor | 1503 Race Ave, Medford, NY 11763-1859 | 2019-11-25 |
| 1427691955 | Claire Elizabeth Ann Vos | Counselor | 807 Impala Dr, Medford, WI 54451-1206 | 2019-10-28 |
| 1033768718 | Hope Koram | Counselor | 15 Carberry St, Medford, MA 02155-1804 | 2019-09-05 |
| 1649767203 | Kerry Ellis | Counselor | 190 High St Apt 210, Medford, MA 02155-3810 | 2018-04-19 |
| 1942701271 | Winding Tree Counseling Services LLC | Counselor | 916 W 10th St Ste 100, Medford, OR 97501-3018 | 2018-02-22 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.