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Slade F Thackeray , LPC

Counselor β€’ Dallas, OR

Active NPI 1992460703 Individual Practitioner Male Practitioner
Practice location in NPPES

1151 Sw Levens St
Dallas, OR 973382266

Call 5039106822 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1151 Sw Levens St

Dallas, OR 973382266

Telephone 5039106822
Fax 9713572444
Organization at the Same NPPES Address or Phone
Sparrow Professional Development & Counseling Center Facility NPI 1881358901

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2021

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Slade Thackeray has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Slade Thackeray as eligible to order or refer Medicare Part B clinical laboratory and imaging services and durable medical equipment (DME) for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Dallas and Oregon

11 active clinicians are listed under Counselor with a practice address in Dallas, OR (4,471 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Dallas

0% of these 11 clinicians have the CMS telehealth indicator.

0% of these 11 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-05-28
Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

License # reported to NPPES OR C8279

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Counselor - Mental Health

NUCC Taxonomy Code: 101YM0800X

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - MENTAL HEALTH COUNSELOR

Medicare Enrollment ID

I20240619000311

Enrollment State Jurisdiction

OR

PECOS Control ID

3274076286

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Not Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location May 28, 2024

Registered at 1151 SW LEVENS ST, DALLAS, OR 973382266 (Tel: 5039106822)

πŸ‘€
Provider Name / Credentials Updated May 28, 2024

Recorded as SLADE THACKERAY, LPC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 28, 2024

Counselor (license number reported to NPPES: OR C8279)

βœ…
NPI Profile Active November 05, 2021

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) November 05, 2021

Registered at 607 SE JEFFERSON ST, DALLAS, OR 973382025 (Tel: 5039106822)

πŸ“
Business Mailing Address (Initial Record) November 05, 2021

Registered at 1151 SW LEVENS ST, DALLAS, OR 973382266 (Tel: 5039106822)

πŸ‘€
Provider Name / Credentials (Initial Record) November 05, 2021

Recorded as SLADE THACKERAY

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) November 05, 2021

Counselor

🟒
Initial NPI Registration & Enumeration November 05, 2021

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1992460703
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 05, 2021
Last Update: May 28, 2024
Sole Proprietor: No

Mailing Address

1151 Sw Levens St

Dallas, OR 973382266

Phone: 5039106822

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.