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General NPI Number Information
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NPI Number | 1952605966
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Entity Type | Organization
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Legal Business Name | RODNEY DEAN LCSW PC
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Dates
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Enumeration Date | 01/05/2011
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 1340 CHEMEKETA ST NE
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City | SALEM
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State | OR
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Zip | 97301-4151
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Country | US
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Telephone | 503-269-4097
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Fax | 503-588-9996
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Provider Business Mailing Address
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Address Line | 1340 CHEMEKETA ST NE
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City | SALEM
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State | OR
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Zip | 97301-4151
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Country | US
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Telephone | 503-269-4097
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Fax | 503-588-9996
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Authorized Official
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Title or Position | PRESIDENT
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Name | RODNEY BRYANT DEAN
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Credential | LCSW
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Telephone | 503-269-4097
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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 | L3037
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License Number State | OR
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