EDWARD ROY MOULTON (NPI# 1720563513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720563513 |
| Entity Type | Individual |
| Full Name | EDWARD ROY MOULTON |
| Credential | QMHA |
| Practice Address |
348 W Adams St Burns OR 97720-1710 |
| Practice Telephone | 5415738376 |
| Practice Fax Number | 5415738378 |
| Mailing Telephone | 5415738376 |
| Mailing Fax Number | 5415738378 |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2018-09-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 120 S Roanoke Ave, Hines, OR 977382576 | 5415731780 |
| Street Address |
348 W ADAMS ST |
| City | BURNS |
| State | OR |
| Zip Code | 97720-1710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205967288 | Carol L Adams | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2007-03-08 |
| 1144862640 | Angela Beth Temple | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2019-10-16 |
| 1669020400 | Maggie Thompson | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2019-08-26 |
| 1356905913 | Beth Galadriel Diamond | Peer Specialist | 348 W Adams St, Burns, OR 97720-1710 | 2019-04-29 |
| 1306400965 | Amber Leigh Wares | Peer Specialist | 348 W Adams St, Burns, OR 97720-1710 | 2019-04-29 |
| 1609330208 | Deanna Dawn Thrall | Community Health Worker | 348 W Adams St, Burns, OR 97720-1710 | 2019-01-28 |
| 1437629789 | Ryan Gunderson | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2018-11-29 |
| 1205301959 | Michole Thane | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2018-10-09 |
| 1225524325 | Mary Hayes | Peer Specialist | 348 W Adams St, Burns, OR 97720-1710 | 2018-07-02 |
| 1952802621 | Robert Reynolds | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2018-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489388 | Courtney Colleen Mcmullen | Speech-Language Pathologist | 860 N. Court Ave, Burns, OR 97720 | 2020-02-19 |
| 1194900399 | Arntz Medical | Nursing Facility/Intermediate Care Facility | 229 N Egan, Burns, OR 97720 | 2008-01-07 |
| 1831231414 | County of Harney | Preventive Medicine | 420 N. Fairview, Burns, OR 97720 | 2007-02-12 |
| 1902956006 | Symmetry Care, Inc. | Counselor | 348 W. Adams, Burns, OR 97720 | 2007-01-11 |
| 1497747745 | Ladd Shaner | Nurse Anesthetist, Certified Registered | 557 W Washington St, Burns, OR 97720 | 2005-08-22 |
| 1700448032 | Allegiant Integrative Medicine | General Practice | 229 N Egan Ave, Burns, OR 97720 | 2019-07-08 |
| 1386008696 | Brittnee Zmuda | Student in an Organized Health Care Education/Training Program | 5005 N Piedras Street, El Paso, TX 97720 | 2016-04-12 |
| 1689812620 | County of Harney | Public Health or Welfare | 420 N. Fairview, Burns, OR 97720 | 2009-01-29 |
| 1912112293 | Richard Thein | Nurse Anesthetist, Certified Registered | 557 W Washington St, Burns, OR 97720 | 2007-05-11 |
| 1124178868 | Symmetry Care, Inc. | Counselor | 348 W. Adams, Burns, OR 97720 | 2007-01-12 |
| Find all providers in zip 97720 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205967288 | Carol L Adams | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2007-03-08 |
| 1902956006 | Symmetry Care, Inc. | Counselor | 348 W. Adams, Burns, OR 97720 | 2007-01-11 |
| 1669020400 | Maggie Thompson | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2019-08-26 |
| 1205301959 | Michole Thane | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2018-10-09 |
| 1952802621 | Robert Reynolds | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2018-02-27 |
| 1649771577 | Jennifer Jenks | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2018-02-26 |
| 1811498777 | Ashley Tiller | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2018-02-26 |
| 1972016137 | Franki Elise Kesling | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2017-11-09 |
| 1942596275 | Symmetry Care Inc. | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2011-06-24 |
| 1619209525 | Mary Katherine Campos | Counselor | 348 W Adams St, Burns, OR 97720-1710 | 2010-02-02 |
| Find all providers in BURNS | ||||
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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.