MEDICARE: HEIDI NORINE ROGERS HUG CADC I

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	010737	OR
2	101YM0800X	Mental Health Counselor	19-QMHA-I002532	OR
3	175T00000X	Peer Specialist	17-CRM-193	OR
4	101YM0800X	Mental Health Counselor	12-06-84	OR

General Provider Information

NPI Number	:	1700227642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI NORINE ROGERS HUG CADC I

Provider Business Mailing Address
First Line	:	3425 13TH ST
Second Line	:
City	:	BAKER CITY
State	:	OR
Zip	:	97814-1340
Country	:	US
Telephone Number	:	541-523-7400
Fax Number	:	541-523-4927

Provider Business Practice Location Address
First Line	:	3700 MIDWAY
Second Line	:
City	:	BAKER CITY
State	:	OR
Zip	:	97814-1466
Country	:	US
Telephone Number	:	541-523-8320
Fax Number	:	541-523-8325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2013
Last Update Date	:	10/27/2022

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