| Thriveworks Clinical - Oregon Llc | |
|
1144 Madison St Ne Ste F Salem OR 97301-7861 | |
| (855) 284-7483 | |
| (617) 807-0958 |
| Full Name | Thriveworks Clinical - Oregon Llc |
|---|---|
| Speciality | Counselor |
| Location | 1144 Madison St Ne Ste F, Salem, Oregon |
| Authorized Official Name and Position | Anthony Centore (CEO) |
| Authorized Official Contact | 5402176461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thriveworks Clinical - Oregon Llc Po Box 748465 Atlanta GA 30374-8465 Ph: (855) 284-7483 | Thriveworks Clinical - Oregon Llc 1144 Madison St Ne Ste F Salem OR 97301-7861 Ph: (855) 284-7483 |
| NPI Number | 1447926928 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 02/11/2025 |
| Certification Date | 02/11/2025 |
| Medicare PECOS PAC ID | 1254715006 |
|---|---|
| Medicare Enrollment ID | O20220829002616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447926928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Christine Salas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083288922 PECOS PAC ID: 0143602235 Enrollment ID: I20220805002278 |
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