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General NPI Number Information
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NPI Number | 1366974347
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Entity Type | Organization
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Legal Business Name | KGS LCSW
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 1983 TAMARACK PL
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City | ASHLAND
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State | OR
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Zip | 97520-3542
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Country | US
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Telephone | 541-821-2596
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Fax | 541-488-7897
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Provider Business Mailing Address
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Address Line | PO BOX 1426
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City | TALENT
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State | OR
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Zip | 97540-1426
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Country | US
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Telephone | 541-821-2596
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Fax | 541-488-7897
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | KRISTINA G SCHWEIKERT
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Credential | LCSW
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Telephone | 541-821-2596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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