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General NPI Number Information
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NPI Number | 1750702809
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Entity Type | Organization
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Legal Business Name | A CLOSER LOOK COUNSELING
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Dates
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Enumeration Date | 12/16/2013
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 631 SPRING CREEK DR
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City | ASHLAND
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State | OR
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Zip | 97520-1454
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Country | US
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Telephone | 541-708-1235
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Fax | 541-708-0676
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Provider Business Mailing Address
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Address Line | 631 SPRING CREEK DR
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City | ASHLAND
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State | OR
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Zip | 97520-1454
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Country | US
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Telephone | 541-708-0676
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Fax | 541-708-0676
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | MS. KAY HAGEN
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Credential | LCSW
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Telephone | 541-708-1235
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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 | 5251
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License Number State | OR
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