Provider Demographics
NPI:1316924889
Name:ALDERSON & ALDERSON LCSW PC
Entity type:Organization
Organization Name:ALDERSON & ALDERSON LCSW PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY ALDERSON & ALDERSON LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:ARLENE
Authorized Official - Last Name:ALDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-581-0808
Mailing Address - Street 1:PO BOX 2166
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97308-2166
Mailing Address - Country:US
Mailing Address - Phone:503-581-0808
Mailing Address - Fax:503-371-0991
Practice Address - Street 1:280 COURT ST NE
Practice Address - Street 2:STES #205 & #210
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3443
Practice Address - Country:US
Practice Address - Phone:503-581-0808
Practice Address - Fax:503-371-0991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR551251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health