Provider Demographics
NPI:1578905410
Name:BEALS, DORI (LPC, CADC I)
Entity Type:Individual
Prefix:
First Name:DORI
Middle Name:
Last Name:BEALS
Suffix:
Gender:F
Credentials:LPC, CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10229 NW SKYLINE HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-2642
Mailing Address - Country:US
Mailing Address - Phone:503-473-4600
Mailing Address - Fax:
Practice Address - Street 1:9860 SW HALL BLVD
Practice Address - Street 2:SUITE E 3
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8896
Practice Address - Country:US
Practice Address - Phone:503-473-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
C2306101YM0800X
OR990342101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)