| Avant Mental Health Llc | |
|
648 Chetco Ave Brookings OR 97415-8010 | |
| (541) 351-9149 | |
| (503) 914-6686 |
| Full Name | Avant Mental Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 648 Chetco Ave, Brookings, Oregon |
| Authorized Official Name and Position | Kellie Marie Creaser (OWNDER) |
| Authorized Official Contact | 3073513666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avant Mental Health Llc 840 Hassett St Brookings OR 97415-7201 Ph: (307) 351-3666 | Avant Mental Health Llc 648 Chetco Ave Brookings OR 97415-8010 Ph: (541) 351-9149 |
| NPI Number | 1801662598 |
|---|---|
| Provider Enumeration Date | 12/04/2023 |
| Last Update Date | 02/27/2024 |
| Certification Date | 02/27/2024 |
| Medicare PECOS PAC ID | 2466898358 |
|---|---|
| Medicare Enrollment ID | O20240314000381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801662598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kellie M Creaser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740821453 PECOS PAC ID: 9739516972 Enrollment ID: I20200227001348 |
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