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Individual

MR. PAUL R LINEBACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S., LPC, LMHC

Contact information

Practice address
1299 NW ELLAN ST STE 3, ROSEBURG, OR 97470-2031
(541) 391-9991
Mailing address
PO BOX 7, ROSEBURG, OR 97470-0001
(541) 391-9991

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH00004271
WA
101YP2500X
Professional Counselor
Primary
C1198
OR

Other

Enumeration date
08/15/2007
Last updated
05/18/2011
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