ROGUE PSYCH CONSULTANTS, LLC (NPI# 1447727110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447727110 |
| Entity Type | Organization |
| Organization Name | ROGUE PSYCH CONSULTANTS, LLC |
| Practice Address |
835 Crater Lake Ave Medford OR 97504-6505 |
| Mailing Address |
Po Box 4752 Medford OR 97501-0197 |
| Practice Telephone | 5415008655 |
| Practice Fax Number | 8004331396 |
| Mailing Telephone | 5415008655 |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2019-08-22 |
| Authorized Official Name | EVAN ALVORD (SOLE MEMBER) |
| Authorized Official Telephone | 5415008655 |
| Authorized Official Credential | PSYCHOLOGIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 625 Stevens St, Medford, OR 975046719 | 5034530269 | |
| 625 Stevens St, Medford, OR 975046719 | 5415008655 | 8004331396 |
| Street Address |
835 CRATER LAKE AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114965894 | Waterford Operations, LLC | Skilled Nursing Facility | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2006-06-03 |
| 1932715612 | Michael Aaron Schwentner | Physical Therapy Assistant | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2020-09-18 |
| 1992329254 | Taylor Carlson | Physical Therapist | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2020-06-02 |
| 1417581315 | Well Spring Health LLC | Nurse Practitioner | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2020-02-28 |
| 1417599713 | Joseph Cataldo | Occupational Therapist | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2019-10-08 |
| 1225550536 | Netania Stepps | Occupational Therapy Assistant | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2017-07-10 |
| 1982126330 | Joey Michael Villarreal | Physical Therapy Assistant | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2017-07-07 |
| 1013458405 | Elysian Health | Nurse Practitioner | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2017-03-17 |
| 1881065753 | Deeti Mali | Physical Therapist | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2015-10-16 |
| 1922495894 | Tammy Lynn Musselman | Occupational Therapy Assistant | 835 Crater Lake Ave, Medford, OR 97504-6505 | 2015-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607464 | Rogue Therapy | Community/Behavioral Health | 328 S Central Ave Ste 213, Medford, OR 97501-7274 | 2020-10-24 |
| 1326671082 | Res-care New Jersey, Inc. | Community/Behavioral Health | 268 Hopewell Rd, Medford, NJ 08055-8149 | 2020-02-20 |
| 1346882461 | Catherine Elizabeth Young | Community/Behavioral Health | 46 Park Ln, Medford, NY 11763-1143 | 2019-10-09 |
| 1861927089 | Leslie Rheault, Lpc | Community/Behavioral Health | 2191 Canal St, Medford, OR 97501-4338 | 2017-04-25 |
| 1497280697 | Inspired Wellness LLC | Community/Behavioral Health | 1883 Orangewood Dr, Medford, OR 97504-5727 | 2017-04-25 |
| 1164971354 | Integrative Counseling & Wellness, LLC | Community/Behavioral Health | 328 S Central Ave Ste 203, Medford, OR 97501-7274 | 2016-09-28 |
| 1437504651 | Hearts With A Mission | Community/Behavioral Health | 711 Medford Ctr # 334, Medford, OR 97504-6772 | 2016-04-25 |
| 1932568425 | Wellness Psychology, LLC | Community/Behavioral Health | 3228 Hillcrest Park Dr, Medford, OR 97504-7657 | 2016-02-12 |
| 1164811873 | Alice M. Jannini Counseling Services, LLC | Community/Behavioral Health | 500 Stokes Rd, Suite B-5, Medford, NJ 08055-2920 | 2015-01-19 |
| 1609292069 | Mindie A Medina | Community/Behavioral Health | 1005 E. Main St, Medford, OR 97504 | 2014-03-10 |
| 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.