| Prineville Counseling Center Llc | |
|
190 Nw 4th St Prineville OR 97754-1820 | |
| (541) 416-3697 | |
| (541) 416-3707 |
| Full Name | Prineville Counseling Center Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 190 Nw 4th St, Prineville, Oregon |
| Authorized Official Name and Position | Donna Hamlin (CLINICAL SUPERVISOR) |
| Authorized Official Contact | 5414163697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prineville Counseling Center Llc 190 Nw 4th St Prineville OR 97754-1820 Ph: (541) 416-3697 | Prineville Counseling Center Llc 190 Nw 4th St Prineville OR 97754-1820 Ph: (541) 416-3697 |
| NPI Number | 1528670908 |
|---|---|
| Provider Enumeration Date | 08/18/2020 |
| Last Update Date | 08/18/2020 |
| Certification Date | 08/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528670908 | NPI | - | NPPES |
| 500696762 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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