Provider Demographics
NPI:1306385786
Name:NORTHWEST COMMUNITY COUNSELING
Entity Type:Organization
Organization Name:NORTHWEST COMMUNITY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL EXECUTIVE/COFOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-740-2864
Mailing Address - Street 1:500 NW HILL RD STE 220-221
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-9508
Mailing Address - Country:US
Mailing Address - Phone:503-376-9290
Mailing Address - Fax:
Practice Address - Street 1:500 NW HILL RD STE 220-221
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-9508
Practice Address - Country:US
Practice Address - Phone:503-376-9290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4363261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)