Provider Demographics
NPI:1467045773
Name:AUSTIN, ALISON REBEKAH (MA LPC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:REBEKAH
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:REBEKAH
Other - Last Name:GADAIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC, CRC
Mailing Address - Street 1:917 S 69TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-7354
Mailing Address - Country:US
Mailing Address - Phone:850-510-1166
Mailing Address - Fax:
Practice Address - Street 1:10 SHELTON MCMURPHEY BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4928
Practice Address - Country:US
Practice Address - Phone:541-485-2711
Practice Address - Fax:888-975-0250
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
ORC6141101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health