Basic Information
Provider Information
NPI: 1992848725
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHLECHT
FirstName: RICHARD
MiddleName: DEAN
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 25363 E BOLTON RD
Address2:  
City: VENETA
State: OR
PostalCode: 974879731
CountryCode: US
TelephoneNumber: 5419351364
FaxNumber:  
Practice Location
Address1: 1790 W 11TH AVE STE 290
Address2:  
City: EUGENE
State: OR
PostalCode: 974023759
CountryCode: US
TelephoneNumber: 5416861262
FaxNumber: 5416860359
Other Information
ProviderEnumerationDate: 02/14/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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