Provider Demographics
NPI:1033776190
Name:ADAIR, EMMITT (QMHP, CADC, SAP)
Entity Type:Individual
Prefix:
First Name:EMMITT
Middle Name:
Last Name:ADAIR
Suffix:
Gender:M
Credentials:QMHP, CADC, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 SUZANNE WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-7619
Mailing Address - Country:US
Mailing Address - Phone:541-345-2800
Mailing Address - Fax:541-345-4419
Practice Address - Street 1:2650 SUZANNE WAY STE 120
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7619
Practice Address - Country:US
Practice Address - Phone:541-345-2800
Practice Address - Fax:541-345-4419
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500763389Medicaid
OR500763640Medicaid