Provider Demographics
NPI:1912019787
Name:ABELSON, DOROTHY ELLEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:ELLEN
Last Name:ABELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 CLASSIC PL
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-5115
Mailing Address - Country:US
Mailing Address - Phone:541-343-8603
Mailing Address - Fax:
Practice Address - Street 1:2290 OAKMONT WAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5519
Practice Address - Country:US
Practice Address - Phone:541-484-9722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR07481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORJ9100OtherPACIFICSOURCE HEALTH PLAN
ORR03099OtherPACIFICARE BEHAVIORAL HEA
ORR03099OtherPACIFICARE BEHAVIORAL HEA