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NPI Code Detail

MEDICARE: SALENE GREEN QMHP,MA

MEDICARE: SALENE GREEN QMHP,MA
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
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3106H00000XMarriage & Family Therapist
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
5261QM0850XAdult Mental Health Clinic/Center
6261QM0855XAdolescent and Children Mental Health Clinic/Center

General Provider Information

NPI Number : 1487786430
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALENE GREEN QMHP,MA
Provider Business Mailing Address
First Line : 348 W ADAMS ST
Second Line :
City : BURNS
State : OR
Zip : 97720-1710
Country : US
Telephone Number : 541-573-8376
Fax Number :
Provider Business Practice Location Address
First Line : 348 W ADAMS ST
Second Line :
City : BURNS
State : OR
Zip : 97720-1710
Country : US
Telephone Number : 541-573-8376
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 09/11/2025

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Directions to “ SALENE GREEN QMHP,MA” Practice Location

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