Provider Demographics
NPI:1336590157
Name:MASSINGALE, MICHELLE (CADC-R)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MASSINGALE
Suffix:
Gender:F
Credentials:CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3247
Mailing Address - Country:US
Mailing Address - Phone:541-484-4428
Mailing Address - Fax:541-484-7212
Practice Address - Street 1:260 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3247
Practice Address - Country:US
Practice Address - Phone:541-686-2688
Practice Address - Fax:541-484-7212
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)