Provider Demographics
NPI:1306083605
Name:MCDERMOTT, ARDATH A (OTR/L, LCSW)
Entity type:Individual
Prefix:MS
First Name:ARDATH
Middle Name:A
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:OTR/L, LCSW
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Mailing Address - Street 1:PO BOX 1787
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-0261
Mailing Address - Country:US
Mailing Address - Phone:541-500-8655
Mailing Address - Fax:800-433-1396
Practice Address - Street 1:905 MAIN ST STE 602
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-5842
Practice Address - Country:US
Practice Address - Phone:541-500-8655
Practice Address - Fax:800-433-1396
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2025-01-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR170061Medicaid