Individual provider · Type 1 NPI

Korben J. Chesnut-Petry, CADC 1

Addiction (Substance Use Disorder) Counselor · Salem, OR

NPI number 1841805959 Active

Practice location

1325 Commercial St SE
Salem, OR 97302-4205

Call (971) 301-9574 Map

Mailing address

1160 Liberty St SE
Salem, OR 97302-4143

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X18-02-03 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1841805959

Korben J. Chesnut-Petry, CADC 1's National Provider Identifier is 1841805959, issued on Sep 15, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Salem, OR. The record was last updated on Sep 15, 2020.