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General NPI Number Information
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NPI Number | 1457464141
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Entity Type | Organization
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Legal Business Name | CASCADE COUNSELING, INCORPORATED
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 10/28/2013
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Provider Practice Location Address
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Address Line | 104 5TH ST
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City | HOOD RIVER
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State | OR
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Zip | 97031-2058
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Country | US
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Telephone | 805-544-1412
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Fax |
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Provider Business Mailing Address
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Address Line | 600 REDONDO CT
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City | GROVER BEACH
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State | CA
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Zip | 93433-2931
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Country | US
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Telephone | 805-544-1412
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. JOLIE CANDACE LUCAS
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Credential | LCSW
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Telephone | 805-544-1412
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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 | 2269
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License Number State | OR
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