Organization
COTTAGE GROVE COUNSELING CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY N REISS LCSW (DIRECTOR)
(541) 686-8060
Entity
Organization
Contact information
Practice address
411 WASHINGTON AVE, COTTAGE GROVE, OR 97424-2060
(541) 942-8060
(541) 942-9849
Mailing address
PO BOX 786, COTTAGE GROVE, OR 97424-0033
(541) 942-8060
(541) 942-9849
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/30/2007
Last updated
08/22/2020
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