Provider Demographics
NPI:1558122325
Name:NEWGRANGE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:NEWGRANGE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:B
Authorized Official - Last Name:DOLL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:503-504-6455
Mailing Address - Street 1:4306 SE ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-5759
Mailing Address - Country:US
Mailing Address - Phone:503-504-6455
Mailing Address - Fax:844-792-9639
Practice Address - Street 1:6510 SE FOSTER RD APT F
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-4686
Practice Address - Country:US
Practice Address - Phone:503-504-6455
Practice Address - Fax:844-792-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-18
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health