Liberty Advocacy Group Inc.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

094003275RN Issued in OR

Legal business name

LIBERTY ADVOCACY GROUP INC.

Practice address

1043 Chetco Ave
Brookings, OR 97415-7152

Phone

(541) 469-7611

Fax

(866) 835-8295

NPI assigned

Dec 7, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Renee Balcom

Title

Founding Director

Phone

(541) 469-7611

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1235474842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4404",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974150068",
            "telephone_number": "541-469-7611",
            "fax_number": "541-661-2369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 CHETCO AVE",
            "city": "BROOKINGS",
            "state": "OR",
            "postal_code": "974157152",
            "telephone_number": "541-469-7611",
            "fax_number": "866-835-8295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY ADVOCACY GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-07",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "BALCOM",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "FOUNDING DIRECTOR",
        "authorized_official_telephone_number": "541-469-7611",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "094003275RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorena Renee Lemos
• Ian Leonard, BCBA
• Bruce Vayntraub Lerner
• Devin Leslie, DPT
• Susan Jan Lewis
• James Lindley
• Carlos Lira
• Living Well Medical, LLC
• Gwen Lovetere, L.AC., M.AC.O.M.
• Luz Family Medical Practice LLC

• Registered Nurse in Brookings, OR
• Providers in Brookings, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.