Individual
JESSICA PADILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADCII QMHAII PSS CH
Contact information
Practice address
3031 NE STEPHENS ST, ROSEBURG, OR 97470-6237
(458) 803-4057
Mailing address
PO BOX 1700, ROSEBURG, OR 97470-0414
(541) 229-7038
(541) 464-4474
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22-II-20220
OR
101YM0800X
Mental Health Counselor
22-QMHA-II-000058
OR
172V00000X
Community Health Worker
THW000002914
OR
175T00000X
Peer Specialist
THW000002914
OR
Other
Enumeration date
01/04/2014
Last updated
03/05/2024
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