Provider Demographics
NPI:1235895715
Name:MELANIE SMITH-THURET PSYCHOTHERAPY CONSULTATION, LLC
Entity Type:Organization
Organization Name:MELANIE SMITH-THURET PSYCHOTHERAPY CONSULTATION, LLC
Other - Org Name:MELANIE SMITH-THURET, M.S., MSW, LCSW PSYCHOTHERAPY & CONSULTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH-THURET
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MSW, LCSW
Authorized Official - Phone:971-803-0543
Mailing Address - Street 1:385 NW 114TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-6129
Mailing Address - Country:US
Mailing Address - Phone:971-803-0543
Mailing Address - Fax:971-275-1479
Practice Address - Street 1:10700 SW BEAVERTON HILLSDALE HWY BLDG 3
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3019
Practice Address - Country:US
Practice Address - Phone:971-803-0543
Practice Address - Fax:971-275-1479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA14676618769OtherINDIVIDUAL NPI