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:
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Health care specialties

SpecialtyCodeLicense #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 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932250560 NPPES
Oregon MEDICAID 500660589

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