Healthcare Provider Details

I. General information

NPI: 1801225628
Provider Name (Legal Business Name): SILVERTON COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2013
Last Update Date: 11/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 DENMARK LOOP
SILVERTON OR
97381-1475
US

IV. Provider business mailing address

80 DENMARK LOOP
SILVERTON OR
97381-1475
US

V. Phone/Fax

Practice location:
  • Phone: 503-559-8500
  • Fax: 503-873-6819
Mailing address:
  • Phone: 503-559-8500
  • Fax: 503-873-6819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3634
License Number StateOR

VII. Legacy identifiers

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

VIII. Authorized Official

Name: CATHY CUMMINGS
Title or Position: BILLER
Credential: LCSW
Phone: 503-873-6819