Provider Demographics
NPI:1679079396
Name:BEAUCHENE, CALEB O'DAY (PRSS, QMHA)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:O'DAY
Last Name:BEAUCHENE
Suffix:
Gender:M
Credentials:PRSS, QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 CENTENNIAL LOOP STE A
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7900
Mailing Address - Country:US
Mailing Address - Phone:541-393-0777
Mailing Address - Fax:541-687-9279
Practice Address - Street 1:2149 CENTENNIAL PLZ
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2456
Practice Address - Country:US
Practice Address - Phone:541-741-7107
Practice Address - Fax:541-687-9279
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR175T00000X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No175T00000XOther Service ProvidersPeer Specialist