Tabula Rasa Wellness LLC

NPI #1205300837 in Salem, Oregon

Provider Information

NPI Number: 1205300837
Entity Type: Organization
Organization Name: Tabula Rasa Wellness LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Jan 16, 2019
Last Updated: Jan 31, 2021

Practice Location

Address: 2105 LIBERTY ST NE
City: Salem
State: Oregon
ZIP Code: 97301-8353
Phone: (503) 967-3428

Authorized Official

Name: LINDSAY CROWNER, LCSW
Title: OWNER/CLINICAL SOCIAL WORKER
Phone: (509) 430-7578

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Clinic/Center - Adult Mental Health — Adult Mental Health	261QM0850X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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