COMMUNITY ROOTS COUNSELING, LLC (NPI# 1417567983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417567983 |
| Entity Type | Organization |
| Organization Name | COMMUNITY ROOTS COUNSELING, LLC |
| Practice Address |
315 Ne Evans St Ste 3 Mcminnville OR 97128-4627 |
| Mailing Address |
Po Box 1147 Mcminnville OR 97128-1147 |
| Practice Telephone | 5035832121 |
| Practice Fax Number | 8558554872 |
| Mailing Telephone | 5035832121 |
| Mailing Fax Number | 8558554872 |
| Enumeration Date | 2020-08-08 |
| Last Update Date | 2020-08-08 |
| Authorized Official Name | MR. JES DIMAS (OWNER) |
| Authorized Official Telephone | 5035832121 |
| Authorized Official Credential | LCSW, LICSW, LSS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500688776 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | COMMUNITY ROOTS COUNSELING, LLC | 315 Ne Evans St Ste 3, Mcminnville, OR 97128 |
| Street Address |
315 NE EVANS ST STE 3 |
| City | MCMINNVILLE |
| State | OR |
| Zip Code | 97128-4627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003245242 | Jes Dimas | Social Worker | 315 Ne Evans St Ste 3, Mcminnville, OR 97128-4627 | 2013-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565035 | Bkd Hillside Opco, LLC | Skilled Nursing Facility | 440 Nw Hillside Park Way, Mcminnville, OR 97128 | 2020-10-16 |
| 1811502636 | Sean Peter Christian Cavaghan | Counselor | 1900 Ne Hwy 99, Suite K, Mcminnville, OR 97128 | 2020-09-09 |
| 1386269637 | Tending The Vineyard | Clinic/Center | 127 Nw Highway 99w, Mcminnville, OR 97128 | 2020-06-12 |
| 1619441094 | Kami Naber | Counselor | 672 Ne Evans St, Mcminnville, OR 97128 | 2019-01-18 |
| 1720552102 | Lauren Nicole Abshire | Counselor | 672 Ne Evans Street, Mcminnville, OR 97128 | 2019-01-18 |
| 1366933376 | Maria G Guerrero | Specialist | 325 Nw Fenton St, Mcminnville, OR 97128 | 2018-05-24 |
| 1235628819 | Julie Luedtke | Health Educator | 300 Sw Hill Road South, Mcminnville, OR 97128 | 2018-05-09 |
| 1356838817 | Jacqueline Ann Hausman | Massage Therapist | 119 Ne 3rd St., Mcminnville, OR 97128 | 2018-04-19 |
| 1366960007 | Alexis R Burke | Counselor | 625 Ne Galloway, Mcminnville, OR 97128 | 2017-09-01 |
| 1871018705 | Amanda Rose Bunch | Counselor | 418 Se Holly Way, Mcminnville, OR 97128 | 2017-08-11 |
| Find all providers in zip 97128 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386269637 | Tending The Vineyard | Clinic/Center | 127 Nw Highway 99w, Mcminnville, OR 97128 | 2020-06-12 |
| 1306385786 | Northwest Community Counseling | Clinic/Center | 500 Nw Hill Rd Ste 220-221, Mcminnville, OR 97128-9508 | 2017-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226625 | Centered Therapy LLC | Clinic/Center | 300 Se Reed Market Rd Ste 260, Bend, OR 97702-3816 | 2020-08-17 |
| 1124637236 | Inner Light Counseling & Bodywork LLC | Clinic/Center | 2520 Chaucer Ct, Eugene, OR 97405-1217 | 2020-07-24 |
| 1912521998 | The Practice of Jeffery Wise Therapeutics Pmhnp-bc | Clinic/Center | 2651 Nw Thurman St Apt 303, Portland, OR 97210-2327 | 2020-06-04 |
| 1326661448 | Kgk Therapeutic Services | Clinic/Center | 1138 Jefferson St, Eugene, OR 97402-5246 | 2020-05-22 |
| 1831723642 | Wild River Counseling and Consultation, LLC | Clinic/Center | 107 E Main St Ste 7, Medford, OR 97501-6022 | 2020-03-02 |
| 1356973010 | Holistic Healing Behavioral Healthcare | Clinic/Center | 5257 Ne Martin Luther King Blvd Ste 201, Portland, OR 97211-3283 | 2020-02-10 |
| 1336786730 | Sarah Kaufman Counseling | Clinic/Center | 492 E 13th Ave Ste 210, Eugene, OR 97401-4268 | 2019-12-04 |
| 1942845805 | I. Keith Orton, Phd | Clinic/Center | 745 Nw Mt Washington Dr Ste 301, Bend, OR 97703-1576 | 2019-11-14 |
| 1407408305 | Adaptability for Life LLC | Clinic/Center | 309 N 1st St, Silverton, OR 97381-1605 | 2019-07-10 |
| 1740844539 | New Avenues for Youth | Clinic/Center | 2595 Christie Dr., Lake Oswego, OR 97034 | 2019-04-26 |
| Find all providers with the same taxonomy | ||||
| City | MCMINNVILLE |
| Zip Code | 97128 |
Please comment or provide details below to improve the information on COMMUNITY ROOTS COUNSELING, LLC.
| 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.