Healthcare Provider Details

I. General information

NPI: 1275934481
Provider Name (Legal Business Name): MS. BARBARA SCHUKART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA A DELANEY PH.D.

II. Dates (important events)

Enumeration Date: 09/07/2014
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 CLUB RD SUITE 120
EUGENE OR
97401-2420
US

IV. Provider business mailing address

66 CLUB RD SUITE 120
EUGENE OR
97401-2420
US

V. Phone/Fax

Practice location:
  • Phone: 541-345-2800
  • Fax:
Mailing address:
  • Phone: 541-345-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC3556
License Number StateOR

VII. Legacy identifiers

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

# 1
Identifier500688819
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: