Neil Nicholson, | |
547 E Pine St Ste 201, Central Point, OR 97502-2444 | |
(541) 423-8151 | |
(541) 423-8505 |
Full Name | Neil Nicholson |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 547 E Pine St Ste 201, Central Point, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720356298 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Entity Name | Southern Oregon Wellness Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1538446315 PECOS PAC ID: 5395903124 Enrollment ID: O20120223000945 |
Mailing Address | Practice Location Address |
---|---|
Neil Nicholson, 891 Ohare Pkwy, Medford, OR 97504-4005 Ph: (541) 414-0362 | Neil Nicholson, 547 E Pine St Ste 201, Central Point, OR 97502-2444 Ph: (541) 423-8151 |
Anne Marie Higby, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4940 Hamrick Rd, Central Point, OR 97502 Phone: 541-690-3600 | |
Eleanor Crescenzi, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1001 Manzanita St, Central Point, OR 97502 Phone: 541-535-6239 | |
Karsten Peterson, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1955 Scenic Ave, Central Point, Central Point, OR 97502 Phone: 541-494-6417 Fax: 541-494-6424 | |
Terri A Hagstrom, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 600 S 2nd St, Central Point, OR 97502 Phone: 541-789-4000 Fax: 541-789-4023 | |
Michael Miller, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 600 South Second, Central Point, OR 97502 Phone: 541-789-4000 Fax: 541-789-4023 |