person
Timothy Paul Landry, LCSW
Mental Health Counselor in Cottage Grove, Oregon
NPI 1700340270

Timothy Paul Landry is a Mental Health Counselor based in Cottage Grove, OR and is specialized in Mental Health. Timothy Paul Landry practices in Cottage Grove, OR and has the professional credentials of LCSW. The NPI Number for Timothy Paul Landry is 1700340270 and holds a License No. L6526 (Oregon).

The current practice location address for Timothy Paul Landry is 1450 Birch Ave, Cottage Grove, OR and can be reached out via phone at 503-347-0003.

Location: 1450 Birch Ave, Cottage Grove, OR, 97424-0010
person
Provider Profile Details
NPI Number
1700340270
Provider Name
Timothy Paul Landry
Credential
LCSW
Provider Entity Type
Individual
Gender
Male
Address
1450 Birch Ave, Cottage Grove, OR, 97424-0010
Phone Number
503-347-0003
Fax Number
Provider Enumeration Date
01/29/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
101YM0800X 01 OR TAX ID
institution
Provider Business Practice Location Address Details
Address
1450 Birch Ave
City
State
Zip
97424-1417
Phone Number
503-347-0003
Fax Number
person
Provider Business Mailing Address Details
Address
1450 Birch Ave
City
State
Zip
97424-1417
Phone Number
503-347-0003
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
L6526 (Oregon)
Definition
Definition to come...
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