| Heart Space | |
|
2355 State St Ste 101 Salem OR 97301-4541 | |
| (541) 829-0592 | |
| Not Available |
| Full Name | Heart Space |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2355 State St Ste 101, Salem, Oregon |
| Authorized Official Name and Position | Karen Haag (FOUNDER/LPC) |
| Authorized Official Contact | 5418290592 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heart Space Po Box 3411 Salem OR 97302-0411 Ph: (541) 829-0592 | Heart Space 2355 State St Ste 101 Salem OR 97301-4541 Ph: (541) 829-0592 |
| NPI Number | 1932933553 |
|---|---|
| Provider Enumeration Date | 08/27/2024 |
| Last Update Date | 10/17/2024 |
| Certification Date | 10/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932933553 | NPI | - | NPPES |
| 500666351 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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