| Stacey Guss Lcsw Llc | |
|
14 Cottage St Medford OR 97504-7332 | |
| (541) 779-2390 | |
| (541) 779-3260 |
| Full Name | Stacey Guss Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 14 Cottage St, Medford, Oregon |
| Authorized Official Name and Position | Stacey Eve Guss (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 5417792390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey Guss Lcsw Llc 14 Cottage St Medford OR 97504-7332 Ph: (541) 779-2390 | Stacey Guss Lcsw Llc 14 Cottage St Medford OR 97504-7332 Ph: (541) 779-2390 |
| NPI Number | 1053730622 |
|---|---|
| Provider Enumeration Date | 04/10/2014 |
| Last Update Date | 04/10/2014 |
| Medicare PECOS PAC ID | 8426276510 |
|---|---|
| Medicare Enrollment ID | O20140903001057 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053730622 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stacey E Guss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073722682 PECOS PAC ID: 5193756765 Enrollment ID: I20050823000883 |
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