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Carolyn Lucille Consoli
Peer Specialist in Corvallis, Oregon
NPI 1063605095

Carolyn Lucille Consoli is a Peer Specialist based in Corvallis, OR. Carolyn Lucille Consoli practices in Corvallis, OR. The NPI Number for Carolyn Lucille Consoli is 1063605095 and holds a License No. THW0001880 (Oregon).

The current practice location address for Carolyn Lucille Consoli is 530 Nw 27Th St, Corvallis, OR and can be reached out via phone at 541-766-6835 and via fax at 541-766-6186. You can also correspond with Carolyn Lucille Consoli through the mailing address at 530 NW 27TH ST, CORVALLIS, OR - 97330-5223 (mailing address contact number: 541-766-6835).

Location: 530 Nw 27Th St, Corvallis, OR, 97330-5223
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063605095
Provider Name
Carolyn Lucille Consoli
Credential
Provider Entity Type
Individual
Gender
Female
Address
530 Nw 27Th St, Corvallis, OR, 97330-5223
Phone Number
541-766-6835
Fax Number
541-766-6186
Provider Enumeration Date
08/22/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
500732717 05 OR
500700084 05 OR
institution
Provider Business Practice Location Address Details
Address
530 Nw 27Th St
City
Corvallis
State
Oregon
Zip
97330-5223
Phone Number
541-766-6835
Fax Number
541-766-6186
person
Provider Business Mailing Address Details
Address
530 Nw 27Th St
City
Corvallis
State
Oregon
Zip
97330-5223
Phone Number
541-766-6835
Fax Number
541-766-6186
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
THW0001880 (Oregon)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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