| Steps To Change, Llc | |
|
971 54th St Springfield OR 97478-5312 | |
| (541) 799-0107 | |
| Not Available |
| Full Name | Steps To Change, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 971 54th St, Springfield, Oregon |
| Authorized Official Name and Position | Michelle Sprouffske (OWNER/CLINICIAN) |
| Authorized Official Contact | 5412323253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Steps To Change, Llc 2555 Portland St Apt 29 Eugene OR 97405-3146 Ph: (541) 799-0107 | Steps To Change, Llc 971 54th St Springfield OR 97478-5312 Ph: (541) 799-0107 |
| NPI Number | 1912631300 |
|---|---|
| Provider Enumeration Date | 07/12/2022 |
| Last Update Date | 06/19/2023 |
| Certification Date | 06/19/2023 |
| Medicare PECOS PAC ID | 2668855149 |
|---|---|
| Medicare Enrollment ID | O20220816002218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912631300 | NPI | - | NPPES |
| 500809862 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michelle Lyn Sprouffske |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407255441 PECOS PAC ID: 7315294543 Enrollment ID: I20180719001327 |
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