Provider Demographics
NPI:1821114836
Name:OYSTER, MICHAEL (LPC, CADC III)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:OYSTER
Suffix:
Gender:M
Credentials:LPC, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4814
Mailing Address - Country:US
Mailing Address - Phone:541-207-6212
Mailing Address - Fax:
Practice Address - Street 1:344 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4814
Practice Address - Country:US
Practice Address - Phone:541-207-6212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCADC III, 95-04-154101YA0400X
ORC1482101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR95-04-154OtherCADC III IN OREGON
ORC1482OtherLPC NUMBER FOR OREGON