| Glyn T Deputy, LPC | |
|
1215 Sw G. Street, Grants Pass, OR 97526-2544 | |
| (541) 476-2373 | |
| (541) 476-1526 |
| Full Name | Glyn T Deputy |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 1215 Sw G. Street, Grants Pass, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164541991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LPC-3109 (Idaho) | Secondary |
| 101YP2500X | Counselor - Professional | C2709 (Oregon) | Primary |
| Entity Name | Providence Health & Services Washington |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477563344 PECOS PAC ID: 0547152217 Enrollment ID: O20040326001151 |
| Entity Name | City Of Valdez |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962525097 PECOS PAC ID: 9931261005 Enrollment ID: O20081224000150 |
| Mailing Address | Practice Location Address |
|---|---|
| Glyn T Deputy, LPC 1215 Sw G. Street, Grants Pass, OR 97526-2544 Ph: (541) 476-2373 | Glyn T Deputy, LPC 1215 Sw G. Street, Grants Pass, OR 97526-2544 Ph: (541) 476-2373 |
Desarae Margaret Lane, Counselor Medicare: Not Enrolled in Medicare Practice Location: 715 Sw Ramsey Ave, Grants Pass, OR 97527 Phone: 541-956-4943 | |
Ms. Lisa Jean Meredith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1215 Sw G St, Grants Pass, OR 97526 Phone: 541-476-2373 Fax: 541-476-1526 | |
Taylor Way, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1750 Nebraska Ave, Grants Pass, OR 97527 Phone: 541-476-3302 | |
Mollie Faye Terpening, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1545 Harbeck Rd, Grants Pass, OR 97527 Phone: 541-476-2373 | |
Tamra Blanchard, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1349 Golden Park Dr Apt B, Grants Pass, OR 97527 Phone: 541-761-3989 Fax: 541-226-2356 | |
Samantha Tevis, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1215 Sw G St, Grants Pass, OR 97526 Phone: 541-476-2373 | |
Seann Gregory, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1750 Nebraska Ave Bldg B, Grants Pass, OR 97527 Phone: 541-956-4943 |