| Roseburg Therapy Llc | |
|
272 Nw Medical Loop Ste E Roseburg OR 97471-5545 | |
| (541) 900-4285 | |
| (888) 810-2993 |
| Full Name | Roseburg Therapy Llc |
|---|---|
| Speciality | Counselor |
| Location | 272 Nw Medical Loop Ste E, Roseburg, Oregon |
| Authorized Official Name and Position | Robert Josh Lydon (OWNER/OPERATOR) |
| Authorized Official Contact | 5419004285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roseburg Therapy Llc 272 Nw Medical Loop Ste E Roseburg OR 97471-5545 Ph: (541) 900-4285 | Roseburg Therapy Llc 272 Nw Medical Loop Ste E Roseburg OR 97471-5545 Ph: (541) 900-4285 |
| NPI Number | 1538665013 |
|---|---|
| Provider Enumeration Date | 04/03/2018 |
| Last Update Date | 09/22/2020 |
| Certification Date | 09/22/2020 |
| Medicare PECOS PAC ID | 6608109475 |
|---|---|
| Medicare Enrollment ID | O20190610002722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538665013 | NPI | - | NPPES |
| 500743892 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | L7631 (Oregon) | Secondary |
| Provider Name | Meredith C Krugel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720271976 PECOS PAC ID: 8224123716 Enrollment ID: I20070928000074 |
| Provider Name | Pernilla L Johansson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114951159 PECOS PAC ID: 4486779832 Enrollment ID: I20100909000195 |
| Provider Name | Cynthia Lea Nesiba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861665614 PECOS PAC ID: 5991999112 Enrollment ID: I20160601001328 |
| Provider Name | Robert J Lydon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407137235 PECOS PAC ID: 4688935596 Enrollment ID: I20180309000222 |
| Provider Name | Alice A Coppers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457685182 PECOS PAC ID: 4688001530 Enrollment ID: I20200305001722 |
| Provider Name | Christine E Cox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518154152 PECOS PAC ID: 0042648560 Enrollment ID: I20200317000549 |
| Provider Name | Brigett W Hollander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578735270 PECOS PAC ID: 9931224912 Enrollment ID: I20201020003612 |
| Provider Name | Lee A Nail |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962951061 PECOS PAC ID: 7911317292 Enrollment ID: I20201028001970 |
| Provider Name | Jacob D Mains |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619283041 PECOS PAC ID: 5991115172 Enrollment ID: I20201028002122 |
| Provider Name | Mary Kay Jabs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366850034 PECOS PAC ID: 8123463445 Enrollment ID: I20240227000863 |
Vituity Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 Nw Stewart Pkwy, Roseburg, OR 97471 Phone: 541-673-0611 | |
Douglas County Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 621 W Madrone St, Roseburg, OR 97470 Phone: 541-440-3532 | |
Kids & Company Counseling, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1813 W Harvard Ave Ste 427, Roseburg, OR 97471 Phone: 907-545-3079 | |
Serenity Lane Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2575 Nw Kline St, Roseburg, OR 97471 Phone: 541-673-3504 Fax: 541-673-4724 | |
Mercy Behavioral Health Unit Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2700 Nw Stewart Pkwy, Roseburg, OR 97470 Phone: 541-677-2458 Fax: 541-677-1554 | |
Community Health Alliance Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1813 W Harvard Ave, Ste 448, Roseburg, OR 97471 Phone: 541-464-4079 Fax: 541-440-6306 | |
Yop Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 Se Jackson St, Roseburg, OR 97470 Phone: 541-672-2691 Fax: 541-673-5642 |