| Counseling Northwest, Llc | |
|
916 W 10th Street Suite 205 Medford OR 97501 | |
| (541) 773-7503 | |
| (541) 776-3007 |
| Full Name | Counseling Northwest, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 916 W 10th Street, Medford, Oregon |
| Authorized Official Name and Position | Blandine Leavitt (OWNER/THERAPIST) |
| Authorized Official Contact | 5417737503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Northwest, Llc Po Box 1799 Jacksonville OR 97530-1799 Ph: (541) 776-7601 | Counseling Northwest, Llc 916 W 10th Street Suite 205 Medford OR 97501 Ph: (541) 773-7503 |
| NPI Number | 1437137312 |
|---|---|
| Provider Enumeration Date | 01/02/2006 |
| Last Update Date | 06/15/2023 |
| Certification Date | 06/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437137312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | NONE (Oregon) | Primary |
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