Provider Demographics
NPI:1154566719
Name:GAMACHE, ABBEY L (LCSW)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:L
Last Name:GAMACHE
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:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OR
Mailing Address - Zip Code:97456
Mailing Address - Country:US
Mailing Address - Phone:541-735-5581
Mailing Address - Fax:
Practice Address - Street 1:171 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2221
Practice Address - Country:US
Practice Address - Phone:541-735-5581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL65011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical