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General NPI Number Information
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NPI Number | 1568089423
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Entity Type | Individual
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Provider Name | MANDEE RAY AWMILLER MSW, LCSW, CADC I
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Gender | Female
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 150 SW 4TH ST
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City | REDMOND
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State | OR
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Zip | 97756-1838
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Country | US
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Telephone | 541-788-0042
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | REDMOND
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State | OR
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Zip | 97756
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Country | US
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Telephone | 541-788-0042
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 21-05-10131
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License Number State | OR
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L11164
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License Number State | OR
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