Healthcare Provider Details

I. General information

NPI: 1881069185
Provider Name (Legal Business Name): MELANIE MAPLES LCSW, QMHPC, CADCIII
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 STERLING DR
EUGENE OR
97404-2292
US

IV. Provider business mailing address

1200 HILYARD ST STE 540
EUGENE OR
97401-8122
US

V. Phone/Fax

Practice location:
  • Phone: 541-799-0958
  • Fax:
Mailing address:
  • Phone: 458-205-7070
  • Fax: 458-205-7089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number23-07-30077
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL11678
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number22-QMHPC-001158
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: