| Sally Crowe Lcsw Llc | |
|
360 Nw Drake Rd Bend OR 97703-2316 | |
| (541) 419-2870 | |
| Not Available |
| Full Name | Sally Crowe Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 360 Nw Drake Rd, Bend, Oregon |
| Authorized Official Name and Position | Sally Crowe (OWNER) |
| Authorized Official Contact | 5414192870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sally Crowe Lcsw Llc Po Box 2303 Bend OR 97709-2303 Ph: (541) 419-2870 | Sally Crowe Lcsw Llc 360 Nw Drake Rd Bend OR 97703-2316 Ph: (541) 419-2870 |
| NPI Number | 1629837380 |
|---|---|
| Provider Enumeration Date | 03/15/2024 |
| Last Update Date | 11/01/2024 |
| Certification Date | 11/01/2024 |
| Medicare PECOS PAC ID | 6103350798 |
|---|---|
| Medicare Enrollment ID | O20241105001213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629837380 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sally A Crowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366619603 PECOS PAC ID: 0547338196 Enrollment ID: I20081008000864 |
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