| Southern Oregon Mental Health Services, Llc | |
|
328 S Central Ave Ste 211 Medford OR 97501-7274 | |
| (541) 531-6312 | |
| (888) 281-8465 |
| Full Name | Southern Oregon Mental Health Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 328 S Central Ave Ste 211, Medford, Oregon |
| Authorized Official Name and Position | Noel Chaney (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 5415316312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Oregon Mental Health Services, Llc Po Box 4322 Medford OR 97501-0165 Ph: (541) 531-6312 | Southern Oregon Mental Health Services, Llc 328 S Central Ave Ste 211 Medford OR 97501-7274 Ph: (541) 531-6312 |
| NPI Number | 1932685963 |
|---|---|
| Provider Enumeration Date | 07/12/2018 |
| Last Update Date | 07/12/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932685963 | NPI | - | NPPES |
| 1942580816 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L7604 (Oregon) | Primary |
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