Provider Demographics
NPI:1013561349
Name:PEOPLES, ELIZABETH (MS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PEOPLES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1780 NORTHVIEW BLVD APT 99
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1677
Mailing Address - Country:US
Mailing Address - Phone:541-510-9122
Mailing Address - Fax:
Practice Address - Street 1:1790 W 11TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3871
Practice Address - Country:US
Practice Address - Phone:541-484-4428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC5859101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health