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SILVER FALLS TRAUMA RECOVERY LLC NPI 1871131201


NPI Information

NPI: 1871131201
Provider Name: SILVER FALLS TRAUMA RECOVERY, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
495 STATE ST STE 540
SALEM, OR
ZIP 97301
Phone: (503) 897-9609
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SILVER FALLS TRAUMA RECOVERY, LLC is a mental health counselor in Salem, OR. SILVER FALLS TRAUMA RECOVERY, LLC NPI is 1871131201. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

495 STATE ST STE 540
SALEM, OR
ZIP 97301-297
Phone: (503) 897-9609

The provider's authorized official is Melinda A Cooper .
The authorized official title is Sole Owner and has the following contact phone number (503) 860-0987.

The enumeration date for this NPI number is 12/16/2019 and was last updated on 12/16/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1500699205MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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