Provider Demographics
NPI:1750601951
Name:MAAS-DESPAIN, ARWEN (LMFT, QMHP)
Entity type:Individual
Prefix:
First Name:ARWEN
Middle Name:
Last Name:MAAS-DESPAIN
Suffix:
Gender:F
Credentials:LMFT, QMHP
Other - Prefix:
Other - First Name:ARWEN
Other - Middle Name:
Other - Last Name:DESPAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:10 SHELTON MCMURPHEY BLVD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4928
Mailing Address - Country:US
Mailing Address - Phone:541-485-2711
Mailing Address - Fax:888-975-0250
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:2010-06-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT1060101YA0400X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500663775Medicaid
ORT1060OtherOBLPCT