| Conifer Wellness, Inc. | |
|
139 Sw 3rd St Corvallis OR 97333-4713 | |
| (347) 782-3046 | |
| Not Available |
| Full Name | Conifer Wellness, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 139 Sw 3rd St, Corvallis, Oregon |
| Authorized Official Name and Position | Sarah Schlatter (CLINIC OWNER) |
| Authorized Official Contact | 5412865002 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conifer Wellness, Inc. Po Box 354 Corvallis OR 97339-0354 Ph: (541) 286-5002 | Conifer Wellness, Inc. 139 Sw 3rd St Corvallis OR 97333-4713 Ph: (347) 782-3046 |
| NPI Number | 1912551771 |
|---|---|
| Provider Enumeration Date | 07/30/2019 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Medicare PECOS PAC ID | 3971916537 |
|---|---|
| Medicare Enrollment ID | O20201229001361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912551771 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Christopher H Smith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922377233 PECOS PAC ID: 0648412072 Enrollment ID: I20130923000098 |
| Provider Name | Jude Thomas Walsh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114190808 PECOS PAC ID: 1254571680 Enrollment ID: I20180614002969 |
| Provider Name | Amber Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356734750 PECOS PAC ID: 8628517232 Enrollment ID: I20240827004224 |
| Provider Name | Brittany Drosdak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265802169 PECOS PAC ID: 0749721272 Enrollment ID: I20240924001505 |
| Provider Name | Hannah Joi Brassell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104315076 PECOS PAC ID: 7517490618 Enrollment ID: I20241029000005 |
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