Individual
MR. KEVIN J NORTHCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II, QMHP-C
Contact information
Practice address
750 FRONT ST NE, SALEM, OR 97301-1089
(503) 363-2021
Mailing address
PO BOX 17818, SALEM, OR 97305-7818
(503) 363-2021
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11-09-82
OR
101YM0800X
Mental Health Counselor
QMHA
OR
171M00000X
Case Manager/Care Coordinator
—
OR
Other
Enumeration date
01/30/2007
Last updated
01/10/2023
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