MICHELLE FONG – Mental Health Counselor, NPI 1821477514
Mental Health Counselor
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
647 CLINICAL PSYCHOLOGIST in OR
Provider Addresses for MICHELLE FONG
5940 Ulali Dr NE
Keizer, OR 973031500
Phone: (971) 358-0622
Type: Location
1170 Pearl St
Eugene, OR 974013541
Phone: (541) 743-4340
Fax: (541) 743-4369
Type: Location
1170 PEARL ST
EUGENE, OR 974013541
Phone: (541) 743-4340
Fax: (541) 743-4369
Type: Mailing
PO BOX 1188
CORVALLIS, OR 973391188
Phone:
Type: Mailing
534 PLEASANT VIEW WAY NW STE 200
ALBANY, OR 973211789
Phone: (541) 812-5760
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20210115002192 | I | Clinical Psychologist | OR | TBD |
| I20250709002536 | I | Clinical Psychologist | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97303)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | ID | |
| Certified Registered Nurse Anesthetist (Crna) | WA | |
| - | ID | |
| Certified Registered Nurse Anesthetist (Crna) | IN | |
| Family Practice | WA | |
| General Surgery | WA | |
| General Surgery | WA | |
| Orthopedic Surgery | ID | |
| Family Practice, Obstetrics/Gynecology | WA | |
| Emergency Medicine | WA |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.