| Orchard Counseling, Llc | |
|
2580 Chuckanut St Eugene OR 97408-7327 | |
| (503) 269-4979 | |
| Not Available |
| Full Name | Orchard Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2580 Chuckanut St, Eugene, Oregon |
| Authorized Official Name and Position | Mitchell Gooch (CLINICAL MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 5032694979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orchard Counseling, Llc 2580 Chuckanut St Eugene OR 97408-7327 Ph: (503) 269-4979 | Orchard Counseling, Llc 2580 Chuckanut St Eugene OR 97408-7327 Ph: (503) 269-4979 |
| NPI Number | 1760053219 |
|---|---|
| Provider Enumeration Date | 07/06/2021 |
| Last Update Date | 09/28/2023 |
| Certification Date | 09/28/2023 |
| Medicare PECOS PAC ID | 5991247116 |
|---|---|
| Medicare Enrollment ID | O20240604000183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760053219 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Mitchell B Gooch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134569890 PECOS PAC ID: 1254873474 Enrollment ID: I20240604000392 |
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