Provider Demographics
NPI:1942962782
Name:EYE TO EYE COUNSELING AND THERAPY LLC
Entity type:Organization
Organization Name:EYE TO EYE COUNSELING AND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:ULREY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-621-1487
Mailing Address - Street 1:980 SW 6TH ST STE 19A
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2910
Mailing Address - Country:US
Mailing Address - Phone:541-476-7688
Mailing Address - Fax:541-476-7688
Practice Address - Street 1:980 SW 6TH ST STE 19A
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2910
Practice Address - Country:US
Practice Address - Phone:541-476-7688
Practice Address - Fax:541-476-7688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty