Healthcare Provider Details

I. General information

NPI: 1700469327
Provider Name (Legal Business Name): GARRISON COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2021
Last Update Date: 05/02/2021
Certification Date: 05/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 MAIN ST STE 412
KLAMATH FALLS OR
97601-6064
US

IV. Provider business mailing address

905 MAIN ST STE 412
KLAMATH FALLS OR
97601-6064
US

V. Phone/Fax

Practice location:
  • Phone: 406-317-3481
  • Fax:
Mailing address:
  • Phone: 406-317-3481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA GARRISON
Title or Position: OWNER MEMBER
Credential: LCSW
Phone: 541-907-1244