Provider Demographics
NPI:1598535320
Name:CENTER FOR ACCEPTANCE AND WELLNESS P.C
Entity Type:Organization
Organization Name:CENTER FOR ACCEPTANCE AND WELLNESS P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:CANSINO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:747-258-5004
Mailing Address - Street 1:141 SW NEWTON DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-9038
Mailing Address - Country:US
Mailing Address - Phone:747-258-5004
Mailing Address - Fax:
Practice Address - Street 1:168 SW COURT ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-3105
Practice Address - Country:US
Practice Address - Phone:503-751-1222
Practice Address - Fax:503-751-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-03
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty