Provider Demographics
NPI:1982772893
Name:LAWS, MARY ELIZABETH (CADC, QHMA)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:LAWS
Suffix:
Gender:F
Credentials:CADC, QHMA
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ELIZABETH
Other - Last Name:LIPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC, QHMA
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:815-572-5513
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:815-572-5513
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR09-09-26101YA0400X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500662854Medicaid