KENNETH EDWARD SERKOWNEK (NPI# 1033356423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033356423 |
Entity Type | Individual |
Full Name | KENNETH EDWARD SERKOWNEK |
Credential | PHD |
Practice Address |
770 Se Kane St Roseburg OR 97470-3943 |
Practice Telephone | 5416730057 |
Practice Fax Number | 5416732270 |
Mailing Telephone | 5416730057 |
Mailing Fax Number | 5416732270 |
Enumeration Date | 2009-01-07 |
Last Update Date | 2009-01-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC1900X |
Psychologist Specialization: Counseling |
587 | OR | Behavioral Health & Social Service Providers |
Street Address |
770 SE KANE ST |
City | ROSEBURG |
State | OR |
Zip Code | 97470-3943 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275597395 | Lisa Hubbard | Social Worker | 770 Se Kane St, Roseburg, OR 97470-3943 | 2006-04-14 |
1295229052 | Jill Ann Williams | Counselor | 770 Se Kane St, Roseburg, OR 97470-3943 | 2018-06-15 |
1851813646 | Keila Elizabeth Lloyd | Counselor | 770 Se Kane St, Roseburg, OR 97470-3943 | 2017-07-12 |
1285163493 | Jeffery W Retke | Counselor | 770 Se Kane St, Roseburg, OR 97470-3943 | 2017-06-09 |
1841673019 | Danielle Marie Pruett | Counselor | 770 Se Kane St, Roseburg, OR 97470-3943 | 2015-07-06 |
1003239195 | Heather Whitney | Counselor | 770 Se Kane St, Roseburg, OR 97470-3943 | 2014-01-27 |
1780007823 | Juliet Swan | Counselor | 770 Se Kane St, Roseburg, OR 97470-3943 | 2014-01-24 |
1780722009 | Margo M Borland | Registered Nurse | 770 Se Kane St, Roseburg, OR 97470-3943 | 2007-02-01 |
1982760344 | Cindy L Shirtcliff | Social Worker | 770 Se Kane St, Roseburg, OR 97470-3943 | 2006-12-29 |
1063585131 | Nancy Yvonne Armand | Marriage & Family Therapist | 770 Se Kane St, Roseburg, OR 97470-3943 | 2006-11-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326547134 | Thoughtwork, LLC | Social Worker | 178 Nw Garden Valley Blvd, Roseburg, OR 97470 | 2018-02-07 |
1063932960 | Go Mo, LLC | Durable Medical Equipment & Medical Supplies | 627 Se Jackson St, Roseburg, OR 97470 | 2017-06-21 |
1497123335 | Brandi N Hamilton | Counselor | 215 S.e. Jackson, Roseburg, OR 97470 | 2015-09-09 |
1285031203 | Aric Fromdahl | Counselor | 215 Se Jackson, Roseburg, OR 97470 | 2014-11-20 |
1801292438 | Robin Knebel | Counselor | 215 Se Jackson St., Roseburg, OR 97470 | 2014-11-10 |
1700282415 | Samantha Marie Shelley | Counselor | 215 Se Jackson Street, Roseburg, OR 97470 | 2014-11-06 |
1043610660 | Cynthia Simmons | Counselor | 150 Ne Kenneth Ford Drive, Roseburg, OR 97470 | 2014-09-02 |
1083025431 | Toni Damewood Msn Pmhnp-bc | Nurse Practitioner | 770 Se Kane Street, Roseburg, OR 97470 | 2014-05-19 |
1801226196 | Denise Ingeman | Registered Nurse | 1548 South East Pine Street, Roseburg, OR 97470 | 2013-11-22 |
1356606909 | Carla Junette Rambel | Massage Therapist | 566 S.e. Jackson, Roseburg, OR 97470 | 2012-07-10 |
Find all providers in zip 97470 |
Taxonomy Code | 103TC1900X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Counseling |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1598897084 | Lawrence J Flanagan | Psychologist | 1652 Nw Hughwood Ct, Roseburg, OR 97470-8844 | 2007-03-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932722345 | Izmirian Counseling, PC | Psychologist | 1450 Se Holgate Blvd, Portland, OR 97202-4717 | 2020-05-19 |
1538728472 | Little Star Psychological Services, LLC | Psychologist | 1127 Lincoln St, Eugene, OR 97401-3695 | 2019-06-12 |
1013573286 | Erin Fuller Crozier | Psychologist | 408 Sw Monroe Ave Ste M252, Corvallis, OR 97333-7210 | 2019-05-14 |
1225506702 | Michele Ribeiro | Psychologist | 511 Nw 11th St, Corvallis, OR 97330-6010 | 2018-11-02 |
1669959078 | Pamela Michelle Taite | Psychologist | 1785 Ne Sandy Blvd Ste 270, Portland, OR 97232-2791 | 2018-07-27 |
1861850737 | Traci Rieckmann | Psychologist | 2925 Ne 53rd Ave, Portland, OR 97213-2437 | 2016-02-05 |
1710370101 | Asha Stephen | Psychologist | 1590 E.13th Ave, Eugene, OR 97403 | 2015-03-10 |
1801289343 | Alisia Caban | Psychologist | 1590 E 13th Ave., University Counseling & Testing Center, Eugene, OR 97403-1280 | 2015-03-09 |
1336532860 | Heather Brooks Morse | Psychologist | 2228 West 25th Place, Eugene, OR 97405 | 2015-03-09 |
1073905758 | Brent Horner | Psychologist | 132 E Broadway Ste 301, Eugene, OR 97401-3154 | 2015-03-04 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.