| Jill A. Grace Hersch Phd Msw Lcsw Pc | |
|
499 Chestnut St Ashland OR 97520-1546 | |
| (541) 488-0883 | |
| (541) 488-0893 |
| Full Name | Jill A. Grace Hersch Phd Msw Lcsw Pc |
|---|---|
| Speciality | Social Worker |
| Location | 499 Chestnut St, Ashland, Oregon |
| Authorized Official Name and Position | Jill A. Grace Hersch (PRESIDENT) |
| Authorized Official Contact | 5414880883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill A. Grace Hersch Phd Msw Lcsw Pc 499 Chestnut St Ashland OR 97520-1546 Ph: (541) 488-0883 | Jill A. Grace Hersch Phd Msw Lcsw Pc 499 Chestnut St Ashland OR 97520-1546 Ph: (541) 488-0883 |
| NPI Number | 1720131725 |
|---|---|
| Provider Enumeration Date | 01/21/2007 |
| Last Update Date | 02/01/2008 |
| Medicare PECOS PAC ID | 0648227835 |
|---|---|
| Medicare Enrollment ID | O20050330001280 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720131725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L3235 (Oregon) | Primary |
| Provider Name | Jill Alison Grace Hersch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992858997 PECOS PAC ID: 1557318748 Enrollment ID: I20101006000472 |
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