Provider Demographics
NPI:1285904094
Name:SUSAN J MCPHERSON PHD PC
Entity type:Organization
Organization Name:SUSAN J MCPHERSON PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:542-342-7230
Mailing Address - Street 1:975 WILLAGILLESPIE RD STE 202
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2104
Mailing Address - Country:US
Mailing Address - Phone:541-342-7230
Mailing Address - Fax:541-343-9801
Practice Address - Street 1:975 WILLAGILLESPIE RD STE 202
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2104
Practice Address - Country:US
Practice Address - Phone:541-342-7230
Practice Address - Fax:541-343-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR593103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR5904Medicare PIN
ORR0000TCHPZMedicare Oscar/Certification