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NPI Code Detail

MEDICARE: MARTHA MECKEL M.A. C.A.D.C. II

MEDICARE: MARTHA MECKEL M.A. C.A.D.C. II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor98-10-29OR
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1912335878
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA MECKEL M.A. C.A.D.C. II
Provider Business Mailing Address
First Line : 1461 OAK ST
Second Line :
City : EUGENE
State : OR
Zip : 97401-4007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1461 OAK ST
Second Line :
City : EUGENE
State : OR
Zip : 97401-4007
Country : US
Telephone Number : 541-687-9141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2013
Last Update Date : 05/01/2014

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