| Laura Brum, | |
|
65 N Highway 101 Ste 208, Warrenton, OR 97146-9371 | |
| (503) 325-5722 | |
| (503) 861-2043 |
| Full Name | Laura Brum |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 65 N Highway 101 Ste 208, Warrenton, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992122717 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0014981 (Colorado) | Secondary |
| 101YP2500X | Counselor - Professional | C9349 (Oregon) | Primary |
| Entity Name | Centennial Mental Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861479677 PECOS PAC ID: 5193717213 Enrollment ID: O20040331000194 |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Brum, 65 N Highway 101 Ste 204, Warrenton, OR 97146-9371 Ph: (503) 325-5722 | Laura Brum, 65 N Highway 101 Ste 208, Warrenton, OR 97146-9371 Ph: (503) 325-5722 |
Kristopher Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 65 North Highway 101, Suite 204, Warrenton, OR 97146 Phone: 503-325-0241 | |
Nicole Elizabeth Vance, CADCII Counselor Medicare: Not Enrolled in Medicare Practice Location: 65 N Highway 101 Ste 208, Warrenton, OR 97146 Phone: 503-325-0241 | |
Roberta Barbour, Counselor Medicare: Not Enrolled in Medicare Practice Location: 65 N Highway 101, Suite 204, Warrenton, OR 97146 Phone: 503-325-0241 | |
Ms. Anne Tlaker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 65 N Highway 101 Ste 204, Warrenton, OR 97146 Phone: 503-325-0241 Fax: 502-861-2043 | |
Ramonda Dawn Vernon, M.ED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 326 Se Marlin Ave, Warrenton, OR 97146 Phone: 503-325-5722 Fax: 503-861-5649 | |
Roger Hayes, CADC I Counselor Medicare: Not Enrolled in Medicare Practice Location: 65 N Highway 101, Suite 204, Warrenton, OR 97146 Phone: 503-325-5722 | |
Cynthia Kaliszewski, Counselor Medicare: Not Enrolled in Medicare Practice Location: 65 N Highway 101 Ste 204, Warrenton, OR 97146 Phone: 503-325-0241 Fax: 503-861-2043 |