| Ms Michele Tantriella-modell, LPC | |
|
66 Club Rd Ste 160, Eugene, OR 97401-2439 | |
| (541) 345-1722 | |
| (541) 485-7049 |
| Full Name | Ms Michele Tantriella-modell |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 29 Years |
| Location | 66 Club Rd Ste 160, Eugene, Oregon |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376828772 | NPI | - | NPPES |
| 500641977 | Medicaid | OR | |
| 14652890 | Other | CAQH ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | C1796 (Oregon) | Secondary |
| 101YP2500X | Counselor - Professional | C1796 (Oregon) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Amber Benson Pmhnp Pc | 3072786755 | 22 |
| Entity Name | Amber Benson Pmhnp Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912042862 PECOS PAC ID: 3072786755 Enrollment ID: O20111025000003 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Michele Tantriella-modell, LPC Po Box 70779, Springfield, OR 97475-0137 Ph: (541) 345-1722 | Ms Michele Tantriella-modell, LPC 66 Club Rd Ste 160, Eugene, OR 97401-2439 Ph: (541) 345-1722 |
Donald Schaefer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 71 Centennial Loop Ste A, Eugene, OR 97401 Phone: 541-505-8426 Fax: 541-515-6938 | |
Miss Rose Marie Woodfin, B.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 780 Hwy 99 N, Eugene, OR 97402 Phone: 541-461-2845 | |
Maleah Lynn Obie Barrett, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1258 High St, Eugene, OR 97401 Phone: 541-342-8437 | |
David Zeiss, Counselor Medicare: Not Enrolled in Medicare Practice Location: 341 E 12th Ave, Eugene, OR 97401 Phone: 541-342-8255 | |
Jennifer Karen Gerrard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1720 W 25th Ave, Eugene, OR 97405 Phone: 541-343-9706 Fax: 541-683-3748 | |
Mr. Adam David Couch, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3692 Hickory Ave, Eugene, OR 97401 Phone: 541-284-7800 | |
Susan Elizabeth Pepper-reed, B.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 1258 High St, Eugene, OR 97401 Phone: 541-342-8437 Fax: 541-242-2999 |