Provider Demographics
NPI:1235837550
Name:NEXUS WEST COUNSELING
Entity Type:Organization
Organization Name:NEXUS WEST COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:POLISZUK
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:503-568-1115
Mailing Address - Street 1:17828 NW LONE ROCK DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-3393
Mailing Address - Country:US
Mailing Address - Phone:503-568-1115
Mailing Address - Fax:866-856-8268
Practice Address - Street 1:10700 SW BEAVERTON HILLSDALE HWY STE 560
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4791
Practice Address - Country:US
Practice Address - Phone:503-568-1115
Practice Address - Fax:866-856-8268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty