| Lina Soares, Lcsw, Llc | |
|
636 Sw 2nd St Corvallis OR 97333-4442 | |
| (541) 230-8497 | |
| (541) 600-3330 |
| Full Name | Lina Soares, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 636 Sw 2nd St, Corvallis, Oregon |
| Authorized Official Name and Position | Lina H Soares (OWNER) |
| Authorized Official Contact | 5412308497 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lina Soares, Lcsw, Llc 1923 Sw Brooklane Dr Corvallis OR 97333-1627 Ph: (541) 230-8497 | Lina Soares, Lcsw, Llc 636 Sw 2nd St Corvallis OR 97333-4442 Ph: (541) 230-8497 |
| NPI Number | 1841813946 |
|---|---|
| Provider Enumeration Date | 05/22/2020 |
| Last Update Date | 05/06/2021 |
| Certification Date | 05/06/2021 |
| Medicare PECOS PAC ID | 7012337702 |
|---|---|
| Medicare Enrollment ID | O20201019002141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841813946 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lina Hofmann Soares |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780211359 PECOS PAC ID: 9830519529 Enrollment ID: I20201019002225 |
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