William Allen Haden Jr.

Individual provider Active NPI Clinical Social Worker · Phoenix, OR

NPI 1740611458 · NPPES record last updated Sep 8, 2020

Key facts

NPI
1740611458
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
L4655 (OR)
Practice address
106 N. Rose Street
Phoenix, OR 97535
Phone
(541) 535-3287
NPI assigned
Dec 5, 2013
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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
L4655ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica del Valle Family Healthcare Center Inc. Past
since Sep 13, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L4655 OR Yes

Addresses

Primary practice location

106 N. Rose Street
Phoenix, OR 97535

Mailing address

931 Chevy Way
Medford, OR 97504-4127
Phone (541) 690-3555

Other names

  • Mr. William Allen Haden Jr. Professional name

Other providers in Phoenix, OR

All providers in Phoenix, OR · Clinical Social Worker in Oregon

Sources for this page

Verify at the official NPI Registry.