| Carson Valley Counseling | |
|
777 High St Ste 130 Eugene OR 97401-2750 | |
| (458) 224-8090 | |
| Not Available |
| Full Name | Carson Valley Counseling |
|---|---|
| Speciality | Counselor |
| Location | 777 High St Ste 130, Eugene, Oregon |
| Authorized Official Name and Position | Holly Cooper (PROVIDER SUPPORT SUPERVISOR) |
| Authorized Official Contact | 5417019950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carson Valley Counseling Po Box 810 Gold Beach OR 97444-0810 Ph: (541) 373-8116 | Carson Valley Counseling 777 High St Ste 130 Eugene OR 97401-2750 Ph: (458) 224-8090 |
| NPI Number | 1225638067 |
|---|---|
| Provider Enumeration Date | 10/30/2020 |
| Last Update Date | 04/26/2022 |
| Certification Date | 08/13/2021 |
| Medicare PECOS PAC ID | 8022415645 |
|---|---|
| Medicare Enrollment ID | O20210924001258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225638067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jason S Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629131305 PECOS PAC ID: 7517234123 Enrollment ID: I20170602001544 |
| Provider Name | Susan F Pascual |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225306574 PECOS PAC ID: 0749508372 Enrollment ID: I20180108002843 |
| Provider Name | Rachel J Hardin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720313760 PECOS PAC ID: 4880936269 Enrollment ID: I20190506000748 |
| Provider Name | Telishay R Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912410820 PECOS PAC ID: 3577976174 Enrollment ID: I20201228001243 |
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