Provider Demographics
NPI:1598421315
Name:HEARTAFIRE LLC
Entity Type:Organization
Organization Name:HEARTAFIRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CLINICAL SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STINES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-495-5111
Mailing Address - Street 1:9370 SW GREENBURG RD STE 202
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5421
Mailing Address - Country:US
Mailing Address - Phone:503-495-5111
Mailing Address - Fax:
Practice Address - Street 1:9370 SW GREENBURG RD STE 202
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5421
Practice Address - Country:US
Practice Address - Phone:503-495-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEARTAFIRE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty