Southern Oregon Cbt LLC
NPI 1306456058 · Clinical Psychologist · Jacksonville, OR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southern Oregon Cbt LLC is a Clinical Psychologist organization in Jacksonville, OR (NPI 1306456058).
Provider details
- NPI number
- 1306456058
- Entity type
- Organization
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Kacy Mullen, Owner(541) 500-8655
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-08-07
- Last updated
- 2024-10-29
- Certified
- 2024-10-29
Frequently asked questions
- What is Southern Oregon Cbt LLC's NPI number?
- Southern Oregon Cbt LLC's National Provider Identifier (NPI) is 1306456058, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Oregon Cbt LLC?
- Southern Oregon Cbt LLC is classified in the NPPES registry as Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Southern Oregon Cbt LLC located?
- Southern Oregon Cbt LLC's practice location on file with NPPES is 235 W Main St, Jacksonville, OR 97530-9278.
- What is Southern Oregon Cbt LLC's phone number?
- The practice phone number listed in the NPPES registry for Southern Oregon Cbt LLC is (541) 204-4933.
- Does Southern Oregon Cbt LLC accept Medicare?
- Southern Oregon Cbt LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southern Oregon Cbt LLC?
- The authorized official listed on Southern Oregon Cbt LLC's NPPES record is Kacy Mullen, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Oregon Cbt LLC's NPI active?
- Yes — Southern Oregon Cbt LLC's NPI (1306456058) is active in the NPPES registry as of the last update on 2024-10-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.