Provider Demographics
NPI:1558404772
Name:SALTHOUSE, CLARE YVONNE (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:YVONNE
Last Name:SALTHOUSE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 NE JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97470-3225
Mailing Address - Country:US
Mailing Address - Phone:541-679-0885
Mailing Address - Fax:
Practice Address - Street 1:612 SE JACKSON ST
Practice Address - Street 2:SUITE 11
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-4989
Practice Address - Country:US
Practice Address - Phone:541-464-6455
Practice Address - Fax:541-464-6457
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional