Laurie J Wittich, | |
3425 13th St, Baker City, OR 97814-1340 | |
(541) 523-7400 | |
(541) 523-4927 |
Full Name | Laurie J Wittich |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 3425 13th St, Baker City, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578933909 | NPI | - | NPPES |
500699838 | Medicaid | OR | |
4559332 | Other | OR | ODL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 19-QMHPC-00903 (Oregon) | Secondary |
101YP2500X | Counselor - Professional | C7897 (Oregon) | Primary |
Entity Name | New Directions Northwest Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1235124462 PECOS PAC ID: 0446572721 Enrollment ID: O20141124001911 |
Mailing Address | Practice Location Address |
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Laurie J Wittich, 3425 13th St, Baker City, OR 97814-1340 Ph: (541) 523-7400 | Laurie J Wittich, 3425 13th St, Baker City, OR 97814-1340 Ph: (541) 523-7400 |
Ms. Amy Cloudt, CADC I Counselor Medicare: Not Enrolled in Medicare Practice Location: 3600 13th St, Baker City, OR 97814 Phone: 541-523-9559 Fax: 541-523-8067 | |
Raeann J Butler, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2200 4th St, Baker City, OR 97814 Phone: 541-523-3646 | |
Cassie Glerup, QMHA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2200 4th St, Baker City, OR 97814 Phone: 541-523-3646 Fax: 541-523-7602 | |
Ted Woodruff, CRM Counselor Medicare: Not Enrolled in Medicare Practice Location: 3425 13th St, Baker City, OR 97814 Phone: 541-523-7400 Fax: 541-523-4927 | |
Shad M Thomas, LCSW, MSW, CADC III Counselor Medicare: Medicare Enrolled Practice Location: 2200 4th St, Baker City, OR 97814 Phone: 541-573-7303 Fax: 541-573-5938 | |
Dara Michelle Fields, FNP Counselor Medicare: Not Enrolled in Medicare Practice Location: 2200 4th Street, Baker City, OR 97814 Phone: 541-523-3646 Fax: 541-523-7602 | |
Katie Elizabeth Leal, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3425 13th St, Baker City, OR 97814 Phone: 541-523-7400 Fax: 541-523-7400 |