| Avid Counseling Services, Llc | |
|
3806 Tillicum Ln Roseburg OR 97471-2271 | |
| (541) 900-8244 | |
| Not Available |
| Full Name | Avid Counseling Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3806 Tillicum Ln, Roseburg, Oregon |
| Authorized Official Name and Position | Jason Wilcox (PARTNER) |
| Authorized Official Contact | 5419008244 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avid Counseling Services, Llc 3806 Tillicum Ln Roseburg OR 97471-2271 Ph: (541) 900-8244 | Avid Counseling Services, Llc 3806 Tillicum Ln Roseburg OR 97471-2271 Ph: (541) 900-8244 |
| NPI Number | 1477261170 |
|---|---|
| Provider Enumeration Date | 11/10/2022 |
| Last Update Date | 07/02/2023 |
| Certification Date | 06/29/2023 |
| Medicare PECOS PAC ID | 8325409774 |
|---|---|
| Medicare Enrollment ID | O20230801002575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477261170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Thaen Saelee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831388461 PECOS PAC ID: 6507270790 Enrollment ID: I20210129001131 |
| Provider Name | Jason Wilcox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225280753 PECOS PAC ID: 6709251093 Enrollment ID: I20230419002003 |
| Provider Name | Charity B Mcsperitt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184914665 PECOS PAC ID: 3577805225 Enrollment ID: I20240207003418 |
| Provider Name | Ryan Daniel Heck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528401478 PECOS PAC ID: 0446570253 Enrollment ID: I20240223002498 |
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Kids & Company Counseling, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1813 W Harvard Ave Ste 427, Roseburg, OR 97471 Phone: 907-545-3079 | |
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Community Health Alliance Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1813 W Harvard Ave, Ste 448, Roseburg, OR 97471 Phone: 541-464-4079 Fax: 541-440-6306 | |
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