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Individual

CARMEN MARIE MACMILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
66 CLUB RD STE 120, EUGENE, OR 97401-2439
(541) 393-5983
(541) 393-5984
Mailing address
66 CLUB RD STE 160, EUGENE, OR 97401-2439
(541) 345-1722
(541) 485-7049

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
C5822
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15091907
CAQH ID
05
500661183
OR
Enumeration date
01/11/2010
Last updated
02/22/2024
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