Provider Demographics
NPI:1356499420
Name:CHEHALEM YOUTH & FAMILY SERVICES
Entity Type:Organization
Organization Name:CHEHALEM YOUTH & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CATHERS-SEYMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-538-4874
Mailing Address - Street 1:504 VILLA RD STE 3
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1851
Mailing Address - Country:US
Mailing Address - Phone:503-538-4874
Mailing Address - Fax:503-538-1271
Practice Address - Street 1:504 VILLA RD STE 3
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1851
Practice Address - Country:US
Practice Address - Phone:503-538-4874
Practice Address - Fax:503-538-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2193101YM0800X, 103G00000X, 103TF0000X
OR201507040NP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR230442OtherDMAP PROVIDER