CLANCY BERGOLD (NPI# 1396058467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396058467 |
| Entity Type | Individual |
| Full Name | CLANCY BERGOLD |
| Practice Address |
5350 Donald St Eugene OR 97405-3529 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5415058558 |
| Practice Fax Number | 5415058558 |
| Mailing Telephone | 5418588170 |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2018-09-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
5350 DONALD ST |
| City | EUGENE |
| State | OR |
| Zip Code | 97405-3529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114401288 | Kokouvi Mp Oni | Counselor | 5350 Donald St, Eugene, OR 97405-3529 | 2018-09-24 |
| 1104305820 | Randi F Eberley | Counselor | 5350 Donald St, Eugene, OR 97405-3529 | 2018-08-13 |
| 1952889230 | Constance A Stewart | Counselor | 5350 Donald St, Eugene, OR 97405-3529 | 2018-07-30 |
| 1760960041 | Amanda Hl Hinds | Counselor | 5350 Donald St, Eugene, OR 97405-3529 | 2018-07-30 |
| 1285111385 | Larissa N Williams | Counselor | 5350 Donald St, Eugene, OR 97405-3529 | 2018-07-23 |
| 1093223737 | Shelby L Oberg | Counselor | 5350 Donald St, Eugene, OR 97405-3529 | 2018-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356985337 | Elizabeth Reed | Doula | 28192 Briggs Hill Rd, ., Eugene, OR 97405 | 2019-11-01 |
| 1235625450 | Kim Lynette Lesh | Counselor | 2434 Jacobs Lane, Eugene, OR 97405 | 2018-07-11 |
| 1841711884 | Mary Fiedler | Massage Therapist | 1924 Jackson Street, Eugene, OR 97405 | 2017-06-29 |
| 1235672478 | Icco LLC | Clinic/Center | 2710 Willamette Street, Eugene, OR 97405 | 2016-11-21 |
| 1033566633 | Andrea Armstrong | Counselor | 3575 Donald St Ste 130, Eugene, OR 97405 | 2016-05-24 |
| 1801265061 | Alani Stuart | Counselor | 3411-a Willamette Street, Eugene, OR 97405 | 2015-09-17 |
| 1992174155 | Lorena Cortes Cervantes | Counselor | 3411-a Willamette Street, Eugene, OR 97405 | 2015-09-17 |
| 1346626926 | Susan White | Speech-Language Pathologist | 3500 Hilyard St., Eugene, OR 97405 | 2015-08-05 |
| 1366826042 | Sherion Fulton | Counselor | 2852 Willamette #278, Eugene, OR 97405 | 2015-07-13 |
| 1336532860 | Heather Brooks Morse | Psychologist | 2228 West 25th Place, Eugene, OR 97405 | 2015-03-09 |
| Find all providers in zip 97405 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467333 | Paula J. Bloom | Counselor | 66 Club Rd Ste No350, Eugene, OR 97401-2420 | 2020-11-06 |
| 1902406903 | Karen Elizabeth Sanchez Dean | Counselor | 1957 Lemming Ave, Eugene, OR 97401-7231 | 2020-10-28 |
| 1356941629 | Alexandra Suzanne Parker | Counselor | 1600 Valley River Dr Ste 100, Eugene, OR 97401-2141 | 2020-10-27 |
| 1417554247 | Counseling Practitioners LLC | Counselor | 1342 High St, Eugene, OR 97401-3237 | 2020-10-05 |
| 1881203404 | Caitlin Joyce, Lcsw LLC | Counselor | 1860 Willamette St Ste 200, Eugene, OR 97401-4044 | 2020-07-29 |
| 1134754013 | Luis Martinez | Counselor | 1973 Garden Avenue, Eugene, OR 97403 | 2020-03-11 |
| 1427681709 | Sarah Voigt | Counselor | 2149 Centennial Plaza Suite #4, Eugene, OR 97401 | 2020-02-14 |
| 1326600453 | Don Sellers Lcsw LLC | Counselor | 1390 Oak St Ste 1, Eugene, OR 97401-3567 | 2019-06-28 |
| 1235796855 | L. Kay Mcdonald | Counselor | 1776 Millrace Dr Ste 200, Eugene, OR 97403-2536 | 2019-05-20 |
| 1093371130 | Rites of The Heart, LLC | Counselor | 1840 Willamette St, Eugene, OR 97401-4601 | 2019-05-14 |
| Find all providers in EUGENE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.