| Lisa Bitikofer, Lcsw, Llc | |
|
145 Wilson St S Salem OR 97302-4232 | |
| (503) 910-4011 | |
| (503) 588-8467 |
| Full Name | Lisa Bitikofer, Lcsw, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 145 Wilson St S, Salem, Oregon |
| Authorized Official Name and Position | Lisa Ann Bitikofer (THERAPIST, OWNER) |
| Authorized Official Contact | 5039104011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Bitikofer, Lcsw, Llc 145 Wilson St S Salem OR 97302-4232 Ph: (503) 910-4011 | Lisa Bitikofer, Lcsw, Llc 145 Wilson St S Salem OR 97302-4232 Ph: (503) 910-4011 |
| NPI Number | 1417301193 |
|---|---|
| Provider Enumeration Date | 04/19/2016 |
| Last Update Date | 04/19/2016 |
| Medicare PECOS PAC ID | 1658660535 |
|---|---|
| Medicare Enrollment ID | O20160516002205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417301193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | L3363 (Oregon) | Primary |
| Provider Name | Lisa A Bitikofer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720121809 PECOS PAC ID: 7214179613 Enrollment ID: I20130814000882 |
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