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NPI Code Detail

MEDICARE: LUTHERAN COMMUNITY SERVICES NW

MEDICARE: LUTHERAN COMMUNITY SERVICES NW
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
1103TC1900XCounseling Psychologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2026825000OTHERORBCBS PROVIDER #
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396862074
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHERAN COMMUNITY SERVICES NW
Provider Business Mailing Address
First Line : 2036 LEROY ST
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-1876
Country : US
Telephone Number : 541-883-3471
Fax Number : 541-883-3524
Provider Business Practice Location Address
First Line : 2545 N ELDORADO AVE
Second Line :
City : KLAMATH FALLS
State : OR
Zip : 97601-6423
Country : US
Telephone Number : 541-883-3471
Fax Number : 541-883-3524
Authorized Official
Title or Position : MENTAL HEALTH COUNSELOR
Name : MS. HEIDI PAGE
Credential : PHD
Telephone Number : 541-883-3471
Provider Enumeration Date : 03/26/2007
Last Update Date : 08/22/2020

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1679798458 — DAVID WESTHART MSW
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Directions to “LUTHERAN COMMUNITY SERVICES NW ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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