Theresa Ann Dudley, LCSW, CADC1 is a
Counselor - Addiction (substance Use Disorder) based in Forest Grove, Oregon. Theresa Ann Dudley is licensed to practice in Oregon (license number 01-11-18) and her current practice location is
1904 Elm St, Suite 5, Forest Grove, Oregon. She can be reached at her office (for appointments etc.) via phone at
(503) 803-0601.
NPI number for Theresa Ann Dudley is 1861619264 and her current mailing address is Po Box 902, Forest Grove, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1861619264.
Healthcare Provider's Profile
| Full Name | Theresa Ann Dudley |
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| Gender | Female |
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| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 1904 Elm St, Forest Grove, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1861619264
- Provider Enumeration Date: 04/19/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Theresa Ann Dudley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861619264 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | L3637 (Oregon) | Primary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 01-11-18 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theresa Ann Dudley is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Theresa Ann Dudley, LCSW, CADC1
Po Box 902,
Forest Grove, OR 97116-0902
Ph: () - | Theresa Ann Dudley, LCSW, CADC1
1904 Elm St, Suite 5,
Forest Grove, OR 97116-2553
Ph: (503) 803-0601 |
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