Provider Demographics
NPI:1346556693
Name:SPROUL, JANE M (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:M
Last Name:SPROUL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 NW THURMAN ST STE E
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2581
Mailing Address - Country:US
Mailing Address - Phone:971-227-5181
Mailing Address - Fax:971-277-7694
Practice Address - Street 1:2301 NW THURMAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2581
Practice Address - Country:US
Practice Address - Phone:971-227-5181
Practice Address - Fax:971-277-7694
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
ORC2702101YP2500X
ORR1552101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional