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Deactivated NPI 1306401997 Deactivated / Inactive NPI Male Practitioner

Robert Steven Amavisca

Counselor • Salem, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Robert Amavisca has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 08, 2019
NPI Deactivation Date June 19, 2025
Total Practice Duration ~6 Years of Practice (2019 – 2025)

Professional Overview & Biography Verified Profile Summary

Robert Amavisca was a registered Counselor practicing in Salem, OR. Throughout an active medical career spanning 6 years, Robert Amavisca provided care at the practice location at 2645 PORTLAND RD NE STE 120 until profile deactivation on 2025-06-19.

Practice Location & Contact Primary Location

Practice Address

2645 Portland Rd Ne Ste 120

Salem, OR 973010200

Telephone 5033905367

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Salem, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.4 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
197 Specialists

Practicing in Salem, OR (4551 Statewide)

Telehealth Adoption Rate
1.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Rose Walker

Counselor

NPI 1043951593
Jonathan Brubaker

Case Manager/Care Coordinator

NPI 1053990101
Sara Mcninch

Peer Specialist

NPI 1063236065
Mayra Larios

Counselor

NPI 1083976328
Danna Jones

Social Worker

NPI 1114283330
Patricia Brinlee

Social Worker

NPI 1114536265

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 19, 2025

Record deactivated on June 19, 2025

NPI Profile Active May 08, 2019

NPI status registered as active in NPPES database

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Updated Practice Location May 08, 2019

Registered at 2645 PORTLAND RD NE STE 120, SALEM, OR 973010200 (Tel: 5033905367)

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Updated Business Mailing Address May 08, 2019

Registered at 3827 MCKENZIE PASS WAY NE APT 101, SALEM, OR 973053999 (Tel: 6028180842)

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Provider Name / Credentials Updated May 08, 2019

Recorded as ROBERT AMAVISCA

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 08, 2019

Counselor

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Initial NPI Registration & Enumeration May 08, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306401997
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 08, 2019
Last Update: May 08, 2019
Deactivation Date: June 19, 2025

Mailing Address

3827 Mckenzie Pass Way Ne Apt 101

Salem, OR 973053999

Phone: 6028180842

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.