| Lee Painter Lcsw Llc | |
|
336 Ne Norton Ave Ste 2 Bend OR 97701-4386 | |
| (541) 948-7499 | |
| (888) 972-8921 |
| Full Name | Lee Painter Lcsw Llc |
|---|---|
| Speciality | Counselor |
| Location | 336 Ne Norton Ave Ste 2, Bend, Oregon |
| Authorized Official Name and Position | Israel L Painter (OWNER) |
| Authorized Official Contact | 5419487499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lee Painter Lcsw Llc 336 Ne Norton Ave Ste 2 Bend OR 97701-4386 Ph: (541) 948-7499 | Lee Painter Lcsw Llc 336 Ne Norton Ave Ste 2 Bend OR 97701-4386 Ph: (541) 948-7499 |
| NPI Number | 1083188031 |
|---|---|
| Provider Enumeration Date | 01/13/2019 |
| Last Update Date | 08/16/2023 |
| Certification Date | 08/16/2023 |
| Medicare PECOS PAC ID | 9931438058 |
|---|---|
| Medicare Enrollment ID | O20190913002507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083188031 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Israel L Painter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750564423 PECOS PAC ID: 4981788718 Enrollment ID: I20080303000561 |
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