Individual provider · Type 1 NPI

Gladys Shade, QMHP, LCSW

Clinical Social Worker · North Bend, OR

NPI number 1114137494 Active

Practice location

1890 Waite St, Suite 1
North Bend, OR 97459-1229

Call (541) 756-6232 Map

Fax (541) 756-6234

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X3124 (OR)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1114137494

Gladys Shade, QMHP, LCSW's National Provider Identifier is 1114137494, issued on May 23, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in North Bend, OR. The record was last updated on Dec 2, 2008.