Organization
FERNREACH, LLC.
Active
Other names
FernReach, LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIA CLARKE LCSW (OWNER)
(541) 915-2690
Entity
Organization
Contact information
Practice address
304 S 13TH ST, COTTAGE GROVE, OR 97424-2315
(458) 201-4911
(541) 228-9370
Mailing address
314 S 13TH ST, COTTAGE GROVE, OR 97424-2315
(541) 915-2690
(541) 228-9370
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019047
—
OR
01
—
500660349
DMAP
OR
Enumeration date
05/20/2022
Last updated
05/20/2022
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