Nicholas Landreth
Individual provider Active NPI Mental Health Counselor · Boardman, OR
NPI 1376901959 · NPPES record last updated Feb 10, 2016
Key facts
- NPI
- 1376901959
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 70362 Kunze LN
Boardman, OR 97818-8013 - Phone
- (541) 481-3233
- Fax
- (541) 481-3234
- NPI assigned
- Feb 10, 2016
- Sex
- Male
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
70362 Kunze LN
Boardman, OR 97818-8013
Mailing address
3587 Heathrow Way
Medford, OR 97504-4004
Phone (541) 310-2010
Other providers in Boardman, OR
- Eunice Amanda Johnson
- Brandon Manuel Juarez Garcia
- Ziyad Amir Kadir
- Brett Andrew Koss
- John Landreth
- Jeremy Larson
- Yves A Lefranc
- Valerie R Lejjena
- Connie Ray Lindstrom
- Carla C Llamas
All providers in Boardman, OR · Mental Health Counselor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.