Provider Demographics
NPI:1477699429
Name:CARRIG, TOD J (LPC, CADC III)
Entity Type:Individual
Prefix:MR
First Name:TOD
Middle Name:J
Last Name:CARRIG
Suffix:
Gender:M
Credentials:LPC, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 N MISSISSIPPI AVE APT A518
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1386
Mailing Address - Country:US
Mailing Address - Phone:503-998-6610
Mailing Address - Fax:
Practice Address - Street 1:3850 N MISSISSIPPI AVE APT A518
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1386
Practice Address - Country:US
Practice Address - Phone:503-998-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2378101YM0800X
OR08-12-77101YA0400X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health