ANNE M WILLIS - NPI NUMBER 1275882854

Summary

Provider Name: ANNE M WILLIS

NPI Number: 1275882854

Clasification: Counselor (101YM0800X)

Specialization: Mental Health

Organization: OPTIONS FOR SOUTHERN OREGON

Address:
1545 HARBECK RD
GRANTS PASS, OR
ZIP 97527

Phone Number: (541) 659-3198



Detailed Information

Anne M Willis is a mental health counselor in Grants Pass, OR with 3 years of experience. The assigned NPI number for this provider is 1275882854 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

1545 HARBECK RD
GRANTS PASS, OR
ZIP 97527-605
Phone: (541) 659-3198

The enumeration date for this NPI number is 8/29/2012 and was last updated on 8/29/2012.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 101YM0800X Counselor Mental Health Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1275882854 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name WILLIS The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name ANNE The first name of the provider, if the provider is an individual.
5 Provider Middle Name M The middle name of the provider, if the provider is an individual.
6 Provider First Line Business Practice Location Address 1545 HARBECK RD The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name GRANTS PASS The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name OR The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 975275605 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 5416593198 The telephone number associated with the location address of the provider being identified.
12 Provider Enumeration Date 8/29/2012 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 8/29/2012 The date that a record was last updated or changed.
14 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
15 Healthcare Provider Taxonomy Code 1 101YM0800X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
16 Healthcare Provider Primary Taxonomy Switch 1 Y Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
17 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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