NPI 1659758167 · live from the CMS NPI Registry
Adagio Therapy Center, LLC
Psychologist, Clinical in Salem, OR. National Provider Identifier 1659758167, active.
NPI record
| NPI | 1659758167 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 388 State St, Suite 707, Salem, OR 97301 |
| Practice phone | 818-253-9264 |
| Enumerated | May 5, 2015 |
| Last updated | May 5, 2015 |
| Authorized official | Martha Wang, Clinical Psychologist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical | 1041C0700X | L6113 (OR) |
| Psychologist, Clinical primary | 103TC0700X | 2518 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.