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Taylor Ellenburg
Peer Specialist in Madras, Oregon
NPI 1457095440

Taylor Ellenburg is a Peer Specialist based in Redmond, OR. Taylor Ellenburg practices in Madras, OR. The NPI Number for Taylor Ellenburg is 1457095440 and holds a License No. THW000106409 (Oregon).

The current practice location address for Taylor Ellenburg is 850 Sw 4Th St, Madras, OR and can be reached out via phone at 541-475-6575.

Location: 850 Sw 4Th St, Madras, OR, 97756-0516
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1457095440
Provider Name
Taylor Ellenburg
Credential
Provider Entity Type
Individual
Gender
Female
Address
850 Sw 4Th St, Madras, OR, 97756-0516
Phone Number
541-475-6575
Fax Number
Provider Enumeration Date
04/25/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
THW000106409 01 OR PEER SUPPORT
institution
Provider Business Practice Location Address Details
Address
850 Sw 4Th St
City
Madras
State
Oregon
Zip
97741-9628
Phone Number
541-475-6575
Fax Number
person
Provider Business Mailing Address Details
Address
850 Sw 4Th St
City
Madras
State
Oregon
Zip
97741-9628
Phone Number
541-475-6575
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
THW000106409 (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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