Provider Demographics
NPI:1033562079
Name:NORTH COAST COUNSELING
Entity Type:Organization
Organization Name:NORTH COAST COUNSELING
Other - Org Name:RORY G GERARD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:RORY
Authorized Official - Middle Name:GIL
Authorized Official - Last Name:GERARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-515-2545
Mailing Address - Street 1:818 COMMERCIAL ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-4547
Mailing Address - Country:US
Mailing Address - Phone:503-515-2545
Mailing Address - Fax:503-961-9858
Practice Address - Street 1:818 COMMERCIAL ST
Practice Address - Street 2:SUITE 303
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-4547
Practice Address - Country:US
Practice Address - Phone:503-515-2545
Practice Address - Fax:503-961-9858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3025101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500653546Medicaid