Healthcare Provider Details

I. General information

NPI: 1437297140
Provider Name (Legal Business Name): VALLEY VIEW MENTAL HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1652 NW HUGHWOOD CT
ROSEBURG OR
97471-8844
US

IV. Provider business mailing address

1652 NW HUGHWOOD CT
ROSEBURG OR
97471-8844
US

V. Phone/Fax

Practice location:
  • Phone: 541-673-3985
  • Fax: 541-673-8060
Mailing address:
  • Phone: 541-673-3985
  • Fax: 541-673-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC0724
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC1119
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC1120
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL3313
License Number StateOR
# 5
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number710
License Number StateOR
# 6
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC0681
License Number StateOR

VIII. Authorized Official

Name: JUDITH K ECKSTEIN
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 541-673-3985