Provider Demographics
NPI:1326685157
Name:CRISPIN COUNSELING LLC
Entity Type:Organization
Organization Name:CRISPIN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CRISPIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT ASSOCIATE
Authorized Official - Phone:503-951-7990
Mailing Address - Street 1:24935 NE PRAIRIE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OR
Mailing Address - Zip Code:97002-9547
Mailing Address - Country:US
Mailing Address - Phone:503-951-7990
Mailing Address - Fax:
Practice Address - Street 1:8995 SW MILEY RD STE 103
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-5485
Practice Address - Country:US
Practice Address - Phone:503-951-7990
Practice Address - Fax:503-785-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-27
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health