Healthcare Provider Details

I. General information

NPI: 1760740070
Provider Name (Legal Business Name): CLAUDE JEREMY HALL LCSW, CADCIII
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 E 12TH AVE
EUGENE OR
97401-3208
US

IV. Provider business mailing address

1258 HIGH ST
EUGENE OR
97401-3238
US

V. Phone/Fax

Practice location:
  • Phone: 541-342-8437
  • Fax:
Mailing address:
  • Phone: 541-342-8437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7277
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: