Provider Demographics
NPI:1255495719
Name:ALLIANCE COUNSELING CENTER, INC
Entity Type:Organization
Organization Name:ALLIANCE COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:KORSCHGEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-221-4531
Mailing Address - Street 1:22018 S CENTRAL POINT RD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013-8705
Mailing Address - Country:US
Mailing Address - Phone:503-412-8149
Mailing Address - Fax:503-263-6278
Practice Address - Street 1:22018 S CENTRAL POINT RD
Practice Address - Street 2:SUITE #3
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013-8705
Practice Address - Country:US
Practice Address - Phone:503-412-8149
Practice Address - Fax:503-263-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0741101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500606514Medicaid