| Connie J Kersenbrock, Lcsw | |
|
300 Se Reed Market Rd Ste 110 Bend OR 97702-2237 | |
| (620) 966-6925 | |
| Not Available |
| Full Name | Connie J Kersenbrock, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 300 Se Reed Market Rd Ste 110, Bend, Oregon |
| Authorized Official Name and Position | Connie Kersenbrock (OWNER) |
| Authorized Official Contact | 6209666925 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connie J Kersenbrock, Lcsw 130 Sw Canyon Dr Apt 3 Redmond OR 97756-2054 Ph: (620) 966-6925 | Connie J Kersenbrock, Lcsw 300 Se Reed Market Rd Ste 110 Bend OR 97702-2237 Ph: (620) 966-6925 |
| NPI Number | 1710528989 |
|---|---|
| Provider Enumeration Date | 09/30/2019 |
| Last Update Date | 09/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710528989 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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