Healthcare Provider Details

I. General information

NPI: 1811343643
Provider Name (Legal Business Name): PAULA LEVINRAD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 W 12TH AVE STE 1
EUGENE OR
97401
US

IV. Provider business mailing address

372 W 12TH AVE STE 1
EUGENE OR
97401-3493
US

V. Phone/Fax

Practice location:
  • Phone: 541-735-3665
  • Fax: 541-981-5165
Mailing address:
  • Phone: 541-735-3665
  • Fax: 541-981-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberL4192
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL4192
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberL4192
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL4192
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PAULA LEVINRAD
Title or Position: PRESIDENT
Credential: LCSW
Phone: 541-913-9603