| Coleen C Moreno, LCSW, LICSW | |
|
1620 E 12th St, The Dalles, OR 97058 | |
| (541) 296-9151 | |
| Not Available |
| Full Name | Coleen C Moreno |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 1620 E 12th St, The Dalles, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821410531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 5249 (Oregon) | Primary |
| Entity Name | Vista Counseling & Consultation Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275864985 PECOS PAC ID: 1153748363 Enrollment ID: O20200902002946 |
| Mailing Address | Practice Location Address |
|---|---|
| Coleen C Moreno, LCSW, LICSW 1620 E 12th St, The Dalles, OR 97058-3213 Ph: (541) 296-9151 | Coleen C Moreno, LCSW, LICSW 1620 E 12th St, The Dalles, OR 97058 Ph: (541) 296-9151 |
Ms. Avie Rice Stacy, MSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1514 E 14th St, The Dalles, OR 97058 Phone: 541-965-1875 | |
Ronald W Wing, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 419 E 7th St Ste 207, The Dalles, OR 97058 Phone: 541-296-5452 Fax: 541-296-4792 | |
Mr. Richard John Friday, LCSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 1620 E 12th St, The Dalles, OR 97058 Phone: 541-296-9151 Fax: 541-296-9156 | |
Mrs. Lacey A Nichols, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1210 Dry Hollow Rd Ste 4 1/2, The Dalles, OR 97058 Phone: 541-240-8938 | |
Tiffany Kenslow, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 508 Washington St, The Dalles, OR 97058 Phone: 541-386-2337 | |
Colin S Wood, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 419 E 7th St Ste 207, The Dalles, OR 97058 Phone: 541-296-5452 Fax: 541-296-4792 | |
Frederick Williams, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1060 Webber St, The Dalles, OR 97058 Phone: 541-296-5452 Fax: 541-296-1537 |