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Ethan Thompson
Peer Specialist in Roseburg, Oregon
NPI 1346005279

Ethan Thompson is a Peer Specialist based in Roseburg, OR. Ethan Thompson practices in Roseburg, OR. The NPI Number for Ethan Thompson is 1346005279 and holds a License No. (Oregon).

The current practice location address for Ethan Thompson is 621 W Madrone St, Roseburg, OR and can be reached out via phone at 541-672-2691. You can also correspond with Ethan Thompson through the mailing address at PO BOX 1121, ROSEBURG, OR - 97470-0254 (mailing address contact number: 541-672-2691).

Location: 621 W Madrone St, Roseburg, OR, 97470-0254
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346005279
Provider Name
Ethan Thompson
Credential
Provider Entity Type
Individual
Gender
Male
Address
621 W Madrone St, Roseburg, OR, 97470-0254
Phone Number
541-672-2691
Fax Number
Provider Enumeration Date
02/20/2024
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
621 W Madrone St
City
Roseburg
State
Oregon
Zip
97470-3090
Phone Number
541-672-2691
Fax Number
person
Provider Business Mailing Address Details
Address
621 W Madrone St
City
Roseburg
State
Oregon
Zip
97470-3090
Phone Number
541-672-2691
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
(Oregon)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Case Manager/Care Coordinator
Speciality
-
Taxonomy
171M00000X
License No.
()
Definition
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.
person
Provider's Taxonomy Details 3
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
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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