Provider Demographics
NPI:1083838726
Name:PATEL, SAJANI MANILAL (LPC)
Entity Type:Individual
Prefix:MS
First Name:SAJANI
Middle Name:MANILAL
Last Name:PATEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7228 N LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-5636
Mailing Address - Country:US
Mailing Address - Phone:909-477-1448
Mailing Address - Fax:
Practice Address - Street 1:15220 NW LAIDLAW RD STE 240
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97229-7718
Practice Address - Country:US
Practice Address - Phone:909-477-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500719611OtherDMAP