RAINA WICKHAM NPI 1457686073

NPI Information

  • NPI: 1457686073
  • Provider Name: RAINA WICKHAM
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1229 MAIN STREET, SUITE 105
    PHILOMATH, OR
    ZIP 97370
  • Phone: (541) 609-1305

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NPI Details

Raina Wickham is a mental health counselor in Philomath, OR. Raina Wickham NPI is 1457686073. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1229 MAIN STREET, SUITE 105
PHILOMATH, OR
ZIP 97370
Phone: (541) 609-1305
Fax: (541) 714-3770

The NPI 1457686073 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/15/2009 and was last updated on 11/8/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)11-12-75OREGONNo
2101YM0800XCounselorMental HealthMASTERS - PSUOREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500658765MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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