Healthcare Provider Details
I. General information
NPI: 1063604668
Provider Name (Legal Business Name): C&R CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/16/2007
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
920 SW FRAZER AVE SUITE 102
PENDLETON OR
97801-2839
US
IV. Provider business mailing address
PO BOX 1205
PENDLETON OR
97801-0170
US
V. Phone/Fax
- Phone: 541-278-8600
- Fax: 541-278-8600
- Phone: 541-278-8600
- Fax: 541-278-8600
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | L1416 |
| License Number State | OR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
CHERYL
A
PRICE
Title or Position: SOCIAL WORKER
Credential: MSW, LCSW
Phone: 541-278-8600