| Swick Clinical Services Inc | |
|
5 Nw Franklin Ave Bend OR 97703-2905 | |
| (541) 241-6123 | |
| Not Available |
| Full Name | Swick Clinical Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5 Nw Franklin Ave, Bend, Oregon |
| Authorized Official Name and Position | Peter Charles Swick (THERAPIST/OWNER) |
| Authorized Official Contact | 4586006101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Swick Clinical Services Inc Po Box 7964 Bend OR 97708-7964 Ph: (541) 241-6123 | Swick Clinical Services Inc 5 Nw Franklin Ave Bend OR 97703-2905 Ph: (541) 241-6123 |
| NPI Number | 1598344590 |
|---|---|
| Provider Enumeration Date | 04/06/2021 |
| Last Update Date | 09/10/2021 |
| Certification Date | 09/10/2021 |
| Medicare PECOS PAC ID | 0547668139 |
|---|---|
| Medicare Enrollment ID | O20211012003171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598344590 | NPI | - | NPPES |
| L8208 | Other | OR | OBLSW LICENSURE |
| 19-10-29 | Other | OR | MHACBO CADC |
| 1982943247 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Peter Charles Swick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982943247 PECOS PAC ID: 3072946680 Enrollment ID: I20191211002195 |
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