Timothy L Koberlein, LCSW | |
702 Sunset Dr, Ontario, OR 97914-3121 | |
(541) 889-9167 | |
(541) 889-7873 |
Full Name | Timothy L Koberlein |
---|---|
Gender | Male |
Speciality | Clinical Social Worker |
Experience | 14 Years |
Location | 702 Sunset Dr, Ontario, Oregon |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235551011 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW-33359 (Idaho) | Secondary |
1041C0700X | Social Worker - Clinical | L6076 (Oregon) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Lifeways Inc | 4183696214 | 12 |
Lifeways Inc | 4183696214 | 12 |
Entity Name | Lifeways Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1568558955 PECOS PAC ID: 4183696214 Enrollment ID: O20040810000531 |
Mailing Address | Practice Location Address |
---|---|
Timothy L Koberlein, LCSW 702 Sunset Dr, Ontario, OR 97914-3121 Ph: (541) 889-9167 | Timothy L Koberlein, LCSW 702 Sunset Dr, Ontario, OR 97914-3121 Ph: (541) 889-9167 |
Genelle Jo Mackey, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 685 N Oregon St, Ontario, OR 97914 Phone: 541-889-2219 | |
Sarah Andrade, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 702 Sunset Dr, Ontario, OR 97914 Phone: 541-889-9167 Fax: 541-889-7873 | |
J. Harrison Whitcomb, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 702 Sunset Dr, Ontario, OR 97914 Phone: 541-889-9167 | |
Ron Vanausdal, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 702 Sunset Dr, Ontario, OR 97914 Phone: 541-889-9167 Fax: 541-889-7873 | |
Ms. Janette Lynn Pennington, CSWA Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1219 Sw 4th Ave, Ontario, OR 97914 Phone: 541-889-2668 | |
Mrs. Jessica Carpenter, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 702 Sunset Dr, Ontario, OR 97914 Phone: 541-889-9167 Fax: 541-881-1503 |