| Evergreen Wellness Counseling Llc | |
|
999 Nw Circle Blvd Corvallis OR 97330-1408 | |
| (541) 754-2225 | |
| Not Available |
| Full Name | Evergreen Wellness Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 999 Nw Circle Blvd, Corvallis, Oregon |
| Authorized Official Name and Position | Angela Mierau (LCSW) |
| Authorized Official Contact | 5417542225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Wellness Counseling Llc 999 Nw Circle Blvd Corvallis OR 97330-1408 Ph: () - | Evergreen Wellness Counseling Llc 999 Nw Circle Blvd Corvallis OR 97330-1408 Ph: (541) 754-2225 |
| NPI Number | 1134907546 |
|---|---|
| Provider Enumeration Date | 09/18/2023 |
| Last Update Date | 11/04/2023 |
| Certification Date | 11/04/2023 |
| Medicare PECOS PAC ID | 6901254176 |
|---|---|
| Medicare Enrollment ID | O20231128003323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134907546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Angela Mierau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992417786 PECOS PAC ID: 1355799529 Enrollment ID: I20231128003382 |
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