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NPI Code Detail

MEDICARE: DIXIE LEE TORSAK CADC, QMHP, PCA

MEDICARE: DIXIE LEE TORSAK CADC, QMHP, PCA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health CounselorC11482OR

General Provider Information

NPI Number : 1790499390
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIXIE LEE TORSAK CADC, QMHP, PCA
Provider Business Mailing Address
First Line : PO BOX 17818
Second Line :
City : SALEM
State : OR
Zip : 97305-7818
Country : US
Telephone Number : 503-363-2021
Fax Number :
Provider Business Practice Location Address
First Line : 750 FRONT ST NE
Second Line :
City : SALEM
State : OR
Zip : 97301-1089
Country : US
Telephone Number : 503-363-2021
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2023
Last Update Date : 04/13/2026

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