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General NPI Number Information
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NPI Number | 1407855653
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Entity Type | Organization
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Legal Business Name | COUNTY OF ADAMS
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 425 E MAIN ST STE 600
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City | OTHELLO
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State | WA
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Zip | 99344-1146
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Country | US
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Telephone | 509-488-4074
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Fax | 509-488-0166
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Provider Business Mailing Address
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Address Line | 425 E MAIN ST STE 600
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City | OTHELLO
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State | WA
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Zip | 99344-1146
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Country | US
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Telephone | 509-488-4074
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Fax | 509-488-0166
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VICKI GUSE
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Credential |
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Telephone | 509-488-4074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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