Provider Demographics
NPI:1215578968
Name:SEVENTH SELF COUNSELING, LLC
Entity Type:Organization
Organization Name:SEVENTH SELF COUNSELING, LLC
Other - Org Name:SEVENTH SELF COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SILVANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOZA LAU
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:541-204-6545
Mailing Address - Street 1:4842 SW ASTER ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1364
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:302 NE PLYMOUTH CIR
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4126
Practice Address - Country:US
Practice Address - Phone:541-204-6545
Practice Address - Fax:541-250-4402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty