Organization
AVID COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON WILCOX LCSW (PARTNER)
(541) 900-8244
Entity
Organization
Contact information
Practice address
3806 TILLICUM LN, ROSEBURG, OR 97471-2271
(541) 900-8244
Mailing address
3806 TILLICUM LN, ROSEBURG, OR 97471-2271
(541) 900-8244
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC1900X
Counseling Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
11/10/2022
Last updated
08/28/2024
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