Mckibben, Carol R
Mckibben, Carol R is an individual health care provider with primary practice located at 621 W. Madrone St , Roseburg OR 97470-3090. She recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as her primary health care specialty. Mckibben, Carol R can be contacted via phone (541) 440-3532.Contact Information
Primary practice address
621 W. Madrone St
Roseburg OR 97470-3090
Phone: (541) 440-3532
Fax: (541) 440-3554
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Counselor | 101Y00000X | ||
Behavioral Health & Social Service Providers / Counselor | 101Y00000X | CSWA A3182 | Oregon |
Profile Details
NPI number | 1932250560 |
---|---|
LBN Legal business name | Mckibben, Carol R |
Credentials | MSW |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jan 12th, 2007 |
Last updated | Mar 28th, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1932250560 | NPPES |
Oregon | MEDICAID | 500660589 |
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