MEDICARE: ALLIANCE COUNSELING, 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1427716117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	PO BOX 1787
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97501-0261
Country	:	US
Telephone Number	:	541-500-8655
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 S GRAPE ST
Second Line	:
City	:	MEDFORD
State	:	OR
Zip	:	97501-3147
Country	:	US
Telephone Number	:	541-500-8655
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINA THOMPSON
Credential	:
Telephone Number	:	541-646-1480

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	02/24/2025

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