| Mashelle Lester Lcsw Llc | |
|
1007 Ne Bitterbrush Rd Prineville OR 97754-8676 | |
| (541) 264-0115 | |
| Not Available |
| Full Name | Mashelle Lester Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1007 Ne Bitterbrush Rd, Prineville, Oregon |
| Authorized Official Name and Position | Mashelle Lester (OWNER) |
| Authorized Official Contact | 5412640115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mashelle Lester Lcsw Llc 1007 Ne Bitterbrush Rd Prineville OR 97754-8676 Ph: (154) 126-4011 | Mashelle Lester Lcsw Llc 1007 Ne Bitterbrush Rd Prineville OR 97754-8676 Ph: (541) 264-0115 |
| NPI Number | 1285309757 |
|---|---|
| Provider Enumeration Date | 08/16/2021 |
| Last Update Date | 08/16/2021 |
| Certification Date | 08/16/2021 |
| Medicare PECOS PAC ID | 7618374372 |
|---|---|
| Medicare Enrollment ID | O20210922001752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285309757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Mashelle D Lester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821458613 PECOS PAC ID: 1456690429 Enrollment ID: I20190308002333 |
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