Provider Demographics
NPI:1013028927
Name:MILNES, JOHN B (LCSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:B
Last Name:MILNES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 LIBERTY ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4347
Mailing Address - Country:US
Mailing Address - Phone:503-585-5328
Mailing Address - Fax:503-588-5327
Practice Address - Street 1:1645 LIBERTY ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4347
Practice Address - Country:US
Practice Address - Phone:503-585-5328
Practice Address - Fax:503-588-5327
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OROR1141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical