Provider Demographics
NPI:1457464141
Name:CASCADE COUNSELING, INCORPORATED
Entity Type:Organization
Organization Name:CASCADE COUNSELING, INCORPORATED
Other - Org Name:CASCADE COUNSELING, INCORPORATED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOLIE
Authorized Official - Middle Name:CANDACE
Authorized Official - Last Name:LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:805-544-1412
Mailing Address - Street 1:600 REDONDO CT
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2931
Mailing Address - Country:US
Mailing Address - Phone:805-544-1412
Mailing Address - Fax:
Practice Address - Street 1:104 5TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-2058
Practice Address - Country:US
Practice Address - Phone:805-544-1412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR109765Medicare PIN