Tom Favreau is a Mental Health in Cottage Grove, Oregon. Tom Favreau practices all healthcare services and medical treatments related to Mental Health. The NPI Number for Tom Favreau is 1306997481. The last update date is 2007-07-09.
Tom Favreau's current location address is 410 N 9th St, Cottage Grove, Oregon. You can contact this provider via phone number 5419422850 and fax number 5419421574. The mailing address for Tom Favreau is 410 N 9th St, Cottage Grove, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tom Favreau |
|---|---|
| Address | 410 N 9th St, Cottage Grove, Oregon |
| Phone Number | 5419422850 |
| Fax Number | 5419421574 |
| Sole Proprietor | N |
| Credentials | QMHP, MA |
NPI Number Detail
| NPI Number | 1306997481 |
|---|---|
| Provider Enumeration Date | 2007-01-15 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 410 N 9th St |
|---|---|
| City | Cottage Grove |
| State | Oregon (OR) |
| Post Code | 974241307 |
| Phone Number | 5419422850 |
| Fax Number | 5419421574 |
Provider's Primary Taxonomy Detail
| Speciality | Mental Health |
|---|---|
| Taxonomy | 101Ym0800X |
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Definition: A counselor who helps people manage conditions like depression, anxiety, grief, relationship issues, and more. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 19047 | OR | -- |
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What is the unique 10-digit identification code issued to Tom Favreau by the Centers for Medicare & Medicaid Services?
The Tom Favreau has been assigned the NPI (National Provider Identifier) 1306997481 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Tom Favreau's facilities are situated?
The facilities of Tom Favreau are physically located at the following address: 410 N 9Th St, Cottage Grove, OR, 974241307.
What is Tom Favreau's specialized field of practice, and what is the corresponding taxonomy classification code?
The Tom Favreau's area of specialization is Mental Health, and the corresponding taxonomy code that categorizes this field of practice is 101Ym0800X.
On what date was the 1306997481 assigned to Tom Favreau?
The Tom Favreau was issued its 1306997481 on 2007-01-15, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Tom Favreau last refreshed?
The information related to the Tom Favreau, including its address, specialty, and other relevant details, was last updated on 2007-07-09.
NPI Number: 1932102142
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