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NPI Code Detail

MEDICARE: KORI CHANCELLOR COUNSELING

MEDICARE: KORI CHANCELLOR COUNSELING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1124841580
Entity Type Code : Organization
Provider Name (Legal Business Name) : KORI CHANCELLOR COUNSELING
Provider Business Mailing Address
First Line : 355 MILLER ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-4247
Country : US
Telephone Number : 503-551-0055
Fax Number :
Provider Business Practice Location Address
First Line : 355 MILLER ST SE
Second Line :
City : SALEM
State : OR
Zip : 97302-4247
Country : US
Telephone Number : 503-551-0055
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KORI ANN CHANCELLOR
Credential : LPC
Telephone Number : 503-551-0055
Provider Enumeration Date : 11/04/2024
Last Update Date : 11/04/2024

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Directions to “KORI CHANCELLOR COUNSELING ” Practice Location

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