Provider Demographics
NPI:1184800187
Name:RESOLUTIONS CREATIVE CONFLICT MANAGEMENT, INC
Entity type:Organization
Organization Name:RESOLUTIONS CREATIVE CONFLICT MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:GROSHONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-383-2004
Mailing Address - Street 1:2052 NE 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3825
Mailing Address - Country:US
Mailing Address - Phone:541-383-2004
Mailing Address - Fax:541-383-2013
Practice Address - Street 1:2052 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-3825
Practice Address - Country:US
Practice Address - Phone:541-383-2004
Practice Address - Fax:541-383-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL3785251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1245241397OtherNPI FOR BETTY GROSHONG
OR1245241397OtherNPI FOR BETTY GROSHONG