Optimize Wellness Counseling Llc | |
632 Anderson Ave Ofc L Coos Bay OR 97420-1632 | |
(541) 297-5449 | |
Not Available |
Full Name | Optimize Wellness Counseling Llc |
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Speciality | Counselor |
Location | 632 Anderson Ave Ofc L, Coos Bay, Oregon |
Authorized Official Name and Position | Desiree Dixon (LICENSED CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 5415902498 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Optimize Wellness Counseling Llc 632 Anderson Ave Ofc L Coos Bay OR 97420-1632 Ph: (541) 590-2498 | Optimize Wellness Counseling Llc 632 Anderson Ave Ofc L Coos Bay OR 97420-1632 Ph: (541) 297-5449 |
NPI Number | 1073209102 |
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Provider Enumeration Date | 04/12/2023 |
Last Update Date | 11/06/2023 |
Certification Date | 11/06/2023 |
Medicare PECOS PAC ID | 6800249277 |
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Medicare Enrollment ID | O20240201002194 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073209102 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Desiree Dixon |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1588188643 PECOS PAC ID: 2567815939 Enrollment ID: I20240201002067 |
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