| Mindful Wellness Llc | |
|
13797 E Evans Creek Rd Rogue River OR 97537-9778 | |
| (541) 973-1361 | |
| Not Available |
| Full Name | Mindful Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 13797 E Evans Creek Rd, Rogue River, Oregon |
| Authorized Official Name and Position | Ashley Shamblin (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5419731361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Wellness Llc Po Box 1504 Rogue River OR 97537-1504 Ph: () - | Mindful Wellness Llc 13797 E Evans Creek Rd Rogue River OR 97537-9778 Ph: (541) 973-1361 |
| NPI Number | 1356108286 |
|---|---|
| Provider Enumeration Date | 03/06/2024 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Medicare PECOS PAC ID | 9739520016 |
|---|---|
| Medicare Enrollment ID | O20240517000968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356108286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ashley Rochell Shamblin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023457504 PECOS PAC ID: 0648611921 Enrollment ID: I20240517001041 |
Rogue Counseling & Consultation Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Pine St Ste C, Rogue River, OR 97537 Phone: 541-500-8655 Fax: 800-433-1396 |