| Four Gates Psychotherapy Llc | |
|
1651 Siskiyou Blvd Ashland OR 97520-2400 | |
| (530) 643-7750 | |
| Not Available |
| Full Name | Four Gates Psychotherapy Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1651 Siskiyou Blvd, Ashland, Oregon |
| Authorized Official Name and Position | Neil R. Nicholson (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5413013559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Four Gates Psychotherapy Llc 400 Cove Rd Ashland OR 97520-9068 Ph: (541) 694-2721 | Four Gates Psychotherapy Llc 1651 Siskiyou Blvd Ashland OR 97520-2400 Ph: (530) 643-7750 |
| NPI Number | 1700661873 |
|---|---|
| Provider Enumeration Date | 08/28/2023 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700661873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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