Provider Demographics
NPI:1285009142
Name:RESTORATION COUNSELING
Entity Type:Organization
Organization Name:RESTORATION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHREINER
Authorized Official - Suffix:
Authorized Official - Credentials:MAC
Authorized Official - Phone:503-351-3197
Mailing Address - Street 1:315 NW ISLAND CIR
Mailing Address - Street 2:APT. B3
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-8334
Mailing Address - Country:US
Mailing Address - Phone:503-351-3197
Mailing Address - Fax:
Practice Address - Street 1:5257 NE MLK JR BLVD
Practice Address - Street 2:SUITE #201
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-3282
Practice Address - Country:US
Practice Address - Phone:503-331-2548
Practice Address - Fax:503-331-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty