Organization · Type 2 NPI

Brainbow Forge

Clinical Social Worker · Coos Bay, OR

NPI number 1659119030 Active

Practice location

137 Hall Ave
Coos Bay, OR 97420-1519

Mailing address

3367 W 18th Ave
Eugene, OR 97402-3109

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Clinical Social Worker Primary 1041C0700XNone listed

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 1659119030

Brainbow Forge's National Provider Identifier is 1659119030, issued on Jul 18, 2024. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Coos Bay, OR. The record was last updated on May 20, 2025.