| Coos County Oregon | |
|
281 Laclair Street Coos Bay OR 97420 | |
| (541) 266-6700 | |
| (541) 888-8726 |
| Full Name | Coos County Oregon |
|---|---|
| Speciality | Clinic/Center |
| Location | 281 Laclair Street, Coos Bay, Oregon |
| Authorized Official Name and Position | Dawn Renee Broughton (ACCOUNTING SUPERVISOR) |
| Authorized Official Contact | 5412666716 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coos County Oregon 281 Laclair Street Coos Bay OR 97420 Ph: (541) 266-6700 | Coos County Oregon 281 Laclair Street Coos Bay OR 97420 Ph: (541) 266-6700 |
| NPI Number | 1811981053 |
|---|---|
| Provider Enumeration Date | 09/02/2005 |
| Last Update Date | 05/22/2025 |
| Certification Date | 05/22/2025 |
| Medicare PECOS PAC ID | 1759353071 |
|---|---|
| Medicare Enrollment ID | O20040818001343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811981053 | NPI | - | NPPES |
| 500500169 | Medicaid | OR | |
| 500602110 | Medicaid | OR |
| Provider Name | Pallav Pareek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922232644 PECOS PAC ID: 9537300215 Enrollment ID: I20130723000064 |
| Provider Name | Kathleen M Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306095955 PECOS PAC ID: 1951460351 Enrollment ID: I20161207000324 |
| Provider Name | Aloycha L De La Roche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568469773 PECOS PAC ID: 2668497017 Enrollment ID: I20190606000879 |
| Provider Name | Mildred L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942267703 PECOS PAC ID: 1052543071 Enrollment ID: I20210811001722 |
| Provider Name | Alisse Anna Diers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922607936 PECOS PAC ID: 6800200973 Enrollment ID: I20210831001451 |
| Provider Name | Demetria Bales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144613134 PECOS PAC ID: 9638577836 Enrollment ID: I20211001000589 |
| Provider Name | Samantha D Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982950432 PECOS PAC ID: 2264689884 Enrollment ID: I20230308002008 |
| Provider Name | Jellirica Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962904722 PECOS PAC ID: 2860756277 Enrollment ID: I20231006002182 |
| Provider Name | Rachelle T Chevalier |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1548631138 PECOS PAC ID: 1557704855 Enrollment ID: I20240202003014 |
| Provider Name | David W Geels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720299480 PECOS PAC ID: 6406038116 Enrollment ID: I20240214004291 |
| Provider Name | Douglas D Shupe |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346556180 PECOS PAC ID: 4587008743 Enrollment ID: I20240215004310 |
| Provider Name | Greg Garrow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295340156 PECOS PAC ID: 5193169019 Enrollment ID: I20240220001008 |
| Provider Name | Karen L Nielsen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184900672 PECOS PAC ID: 2365886157 Enrollment ID: I20240220003810 |
| Provider Name | Jamilah C Mooney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720350606 PECOS PAC ID: 8022454594 Enrollment ID: I20240307001286 |
| Provider Name | Crystal D Schott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245739366 PECOS PAC ID: 6002252095 Enrollment ID: I20240313000809 |
| Provider Name | Trisha A Jordan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700097250 PECOS PAC ID: 7810333812 Enrollment ID: I20240313001242 |
| Provider Name | Megan A Ridle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841448396 PECOS PAC ID: 1254777261 Enrollment ID: I20240313001707 |
| Provider Name | William G Simon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003193657 PECOS PAC ID: 9931545852 Enrollment ID: I20240313002358 |
| Provider Name | Carrie A Aadland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962928630 PECOS PAC ID: 4082051768 Enrollment ID: I20240318003600 |
| Provider Name | Anastasia G Leypold |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285054072 PECOS PAC ID: 7416394440 Enrollment ID: I20240326001270 |
| Provider Name | Sara A Simpkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093362139 PECOS PAC ID: 0547607590 Enrollment ID: I20240326001873 |
| Provider Name | Tina C Lamar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750712527 PECOS PAC ID: 2567800782 Enrollment ID: I20240409000206 |
| Provider Name | Linda K Chastain |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548515745 PECOS PAC ID: 9638512858 Enrollment ID: I20240416003906 |
| Provider Name | Shawna E Schaar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003820283 PECOS PAC ID: 3779923511 Enrollment ID: I20240426002926 |
| Provider Name | Andrea Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295042331 PECOS PAC ID: 6406039460 Enrollment ID: I20250130001138 |
| Provider Name | Ahou B Arterburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174190946 PECOS PAC ID: 4688076763 Enrollment ID: I20250214003176 |
| Provider Name | Alexandra R Micklewright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194554931 PECOS PAC ID: 7214457290 Enrollment ID: I20250224003044 |
Abg Suaimhneas Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 63484 Lightning Rd, Coos Bay, OR 97420 Phone: 858-878-2176 | |
Out Of The Rain Counseling Solutions Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 455 S 4th St Ste 5, Coos Bay, OR 97420 Phone: 541-229-7879 Fax: 541-314-9552 | |
Optimize Wellness Counseling Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 632 Anderson Ave Ofc L, Coos Bay, OR 97420 Phone: 541-297-5449 | |
Oregon Coast Neurology Clinic Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1925 Thompson Rd, Coos Bay, OR 97420 Phone: 541-267-0330 Fax: 541-267-0265 | |
Creative Roots Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 375 Park Ave, Suite B, Coos Bay, OR 97420 Phone: 541-808-4719 | |
Inner Spark Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 134 S Wasson St, Coos Bay, OR 97420 Phone: 971-266-4355 | |
Bob Belloni Ranch Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 Central Ave Ste 406, Coos Bay, OR 97420 Phone: 541-269-0321 Fax: 541-267-0785 |