Provider Demographics
NPI:1558427781
Name:HEALTH PSYCHOLOGY PC
Entity Type:Organization
Organization Name:HEALTH PSYCHOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:THORSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:541-343-7171
Mailing Address - Street 1:1045 WILLAGILLESPIE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6798
Mailing Address - Country:US
Mailing Address - Phone:541-343-7171
Mailing Address - Fax:541-284-1765
Practice Address - Street 1:1045 WILLAGILLESPIE RD
Practice Address - Street 2:STE. 200
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6798
Practice Address - Country:US
Practice Address - Phone:541-343-7171
Practice Address - Fax:541-284-1765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-30
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0755103TC0700X
OR25041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty