MEDICARE: DRUM COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	R4463	OR

General Provider Information

NPI Number	:	1417498395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRUM COUNSELING, LLC

Provider Business Mailing Address
First Line	:	714B MAIN STREET
Second Line	:	SUITE 202
City	:	OREGON CITY
State	:	OR
Zip	:	97045
Country	:	US
Telephone Number	:	503-479-5435
Fax Number	:

Provider Business Practice Location Address
First Line	:	714B MAIN ST
Second Line	:	SUITE 202
City	:	OREGON CITY
State	:	OR
Zip	:	97045-1821
Country	:	US
Telephone Number	:	503-479-5435
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MELISSA RAE DRUM
Credential	:	LPCI
Telephone Number	:	503-926-3589

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	03/13/2017

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