| Green Light Counseling Llc | |
|
4744 Liberty Rd S Ste 20 Salem OR 97302-5181 | |
| (503) 877-3826 | |
| Not Available |
| Full Name | Green Light Counseling Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4744 Liberty Rd S Ste 20, Salem, Oregon |
| Authorized Official Name and Position | Hillary Kay Provance-wheeler (OWNER) |
| Authorized Official Contact | 5038773826 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Light Counseling Llc 4848 Forsythe Dr Se Salem OR 97302-2195 Ph: (503) 949-9685 | Green Light Counseling Llc 4744 Liberty Rd S Ste 20 Salem OR 97302-5181 Ph: (503) 877-3826 |
| NPI Number | 1588387732 |
|---|---|
| Provider Enumeration Date | 09/22/2022 |
| Last Update Date | 09/22/2022 |
| Certification Date | 09/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588387732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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