MEDICARE: SUMMIT THERAPY & WELLNESS LLC

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
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1285436949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT THERAPY & WELLNESS LLC

Provider Business Mailing Address
First Line	:	9582 HILL RD
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-9729
Country	:	US
Telephone Number	:	541-505-4468
Fax Number	:

Provider Business Practice Location Address
First Line	:	9582 HILL RD
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-9729
Country	:	US
Telephone Number	:	541-505-4468
Fax Number	:

Authorized Official
Title or Position	:	OWNER: PROFESSIONAL COUNSELOR ASSOC
Name	:	DEANNA PADGET
Credential	:
Telephone Number	:	541-505-4468

Provider Enumeration Date	:	03/25/2025
Last Update Date	:	03/25/2025

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Directions to “SUMMIT THERAPY & WELLNESS LLC ” Practice Location

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