Healthcare Provider Details

I. General information

NPI: 1851504021
Provider Name (Legal Business Name): JEFFREY L LENKER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E 10TH AVE STE 330
EUGENE OR
97401-3357
US

IV. Provider business mailing address

2650 SUZANNE WAY 120
EUGENE OR
97408-7619
US

V. Phone/Fax

Practice location:
  • Phone: 800-922-7009
  • Fax: 877-730-5113
Mailing address:
  • Phone: 541-345-2800
  • Fax: 541-345-4419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL2617
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier810573161
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerCLINIC TAX ID
# 2
Identifier844704001
Identifier TypeOTHER
Identifier StateOR
Identifier IssuerREGENCE BCBSO PROV NO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: