Provider Demographics
NPI:1598433443
Name:EMERALD BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:EMERALD BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAEGAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MEXICOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-224-7563
Mailing Address - Street 1:1029 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-3242
Mailing Address - Country:US
Mailing Address - Phone:541-224-7585
Mailing Address - Fax:
Practice Address - Street 1:1029 RIVER RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-3242
Practice Address - Country:US
Practice Address - Phone:541-224-7585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty