| Coastal Center For Collaborative Health | |
|
923 Nw Grant Ave Corvallis OR 97330-4503 | |
| (541) 557-1892 | |
| Not Available |
| Full Name | Coastal Center For Collaborative Health |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 923 Nw Grant Ave, Corvallis, Oregon |
| Authorized Official Name and Position | Julie Ramisch (LMFT, OWNER) |
| Authorized Official Contact | 5415571892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Center For Collaborative Health Po Box 2298 Corvallis OR 97339-2298 Ph: (805) 570-4160 | Coastal Center For Collaborative Health 923 Nw Grant Ave Corvallis OR 97330-4503 Ph: (541) 557-1892 |
| NPI Number | 1902259823 |
|---|---|
| Provider Enumeration Date | 07/15/2016 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Medicare PECOS PAC ID | 7810335767 |
|---|---|
| Medicare Enrollment ID | O20240410003816 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902259823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | T1160 (Oregon) | Primary |
| Provider Name | Julie Ramisch |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1265662134 PECOS PAC ID: 8729426671 Enrollment ID: I20240410003846 |
| Provider Name | John L Butler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1578806980 PECOS PAC ID: 5698115046 Enrollment ID: I20240731002342 |
| Provider Name | Jacob Merritt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831705920 PECOS PAC ID: 2163862681 Enrollment ID: I20240731002670 |
| Provider Name | Christa Faith Bhagat Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467071381 PECOS PAC ID: 2769917947 Enrollment ID: I20241125002648 |
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