Desiree Thompson

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

NPI 1124552872 · NPPES record last updated Apr 19, 2017

Key facts

NPI
1124552872
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
149 N Main St
Phoenix, OR 97535
Phone
(541) 535-4133
NPI assigned
Apr 19, 2017
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

149 N Main St
Phoenix, OR 97535

Mailing address

149 N Main St.
Phoenix, OR 97535
Phone (541) 210-3527

Other providers in Phoenix, OR

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

Sources for this page

Verify at the official NPI Registry.