NPI 1740698471 · live from the CMS NPI Registry
Tracy Renee Adevai, LCSW
Social Worker, Clinical in Roseburg, OR. National Provider Identifier 1740698471, active.
NPI record
| NPI | 1740698471 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 285 Se Fowler St, Roseburg, OR 97470 |
| Practice phone | 541-671-5185 |
| Mailing address | Po Box 375, Glide, OR 97443 |
| Enumerated | July 25, 2014 |
| Last updated | March 2, 2024 |
| Sole proprietor | Yes |
| Other names | Collidng Rivers Services, LLC |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | — |
| Social Worker, Clinical primary | 1041C0700X | L10899 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.