Laura Anne Emerson, CRM

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

NPI 1669713400 · NPPES record last updated Mar 4, 2013

Key facts

NPI
1669713400
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
12-CRM-006 (OR)
Practice address
125 SW C St
Madras, OR 97741-1458
Phone
(541) 516-4087
Fax
(541) 504-1195
NPI assigned
Mar 4, 2013
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

State licenses

LicenseStateTypeSpecialty
12-CRM-006ORMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12-CRM-006 OR Yes

Addresses

Primary practice location

125 SW C St
Madras, OR 97741-1458

Mailing address

PO Box 1710
Redmond, OR 97756-0516
Phone (541) 516-4087

Other providers in Madras, OR

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

Sources for this page

Verify at the official NPI Registry.