Christopher Bowling

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Coburg, OR

NPI 1114632569 · NPPES record last updated Jan 19, 2023

Key facts

NPI
1114632569
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
T-22-1989 (OR)
Practice address
1 Serenity LN
Coburg, OR 97408-9350
Phone
(541) 687-1110
NPI assigned
Jan 19, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
T-22-1989ORMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Serenity Lane Current
since Aug 18, 2024
Accepting new patients
Serenity Lane Past
since Jan 22, 2023
Accepting new patients

Locations

1 Serenity Ln
Eugene, OR 97408
Phone (541) 284-5704

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X T-22-1989 OR Yes

Addresses

Primary practice location

1 Serenity LN
Coburg, OR 97408-9350

Mailing address

1 Serenity LN
Coburg, OR 97408-9350
Phone (541) 687-1110

Other providers in Coburg, OR

All providers in Coburg, OR · Addiction (Substance Use Disorder) Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.