| Oregon City Counseling, Llc | |
|
714 Main St Ste B207 Oregon City OR 97045-1826 | |
| (503) 891-6200 | |
| Not Available |
| Full Name | Oregon City Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 714 Main St Ste B207, Oregon City, Oregon |
| Authorized Official Name and Position | Slade Wolf (OWNER) |
| Authorized Official Contact | 5038916200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oregon City Counseling, Llc 18616 S Grasle Rd Oregon City OR 97045-8898 Ph: (503) 891-6200 | Oregon City Counseling, Llc 714 Main St Ste B207 Oregon City OR 97045-1826 Ph: (503) 891-6200 |
| NPI Number | 1629602404 |
|---|---|
| Provider Enumeration Date | 03/02/2020 |
| Last Update Date | 03/02/2020 |
| Certification Date | 03/02/2020 |
| Medicare PECOS PAC ID | 0941676878 |
|---|---|
| Medicare Enrollment ID | O20230816002635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629602404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Slade B Wolf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679879316 PECOS PAC ID: 2860868791 Enrollment ID: I20221018003002 |
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