Healthcare Provider Details

I. General information

NPI: 1346913449
Provider Name (Legal Business Name): SHANAI ANN BATSCH QMHA-R, CADC-R
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 W AGEE ST
ROSEBURG OR
97471-2515
US

IV. Provider business mailing address

1255 PEARL ST STE 101
EUGENE OR
97401-3570
US

V. Phone/Fax

Practice location:
  • Phone: 541-799-5386
  • Fax: 541-588-1150
Mailing address:
  • Phone: 541-799-5386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: