Provider Demographics
NPI:1609391309
Name:STUART MALKIN COUNSELING
Entity Type:Organization
Organization Name:STUART MALKIN COUNSELING
Other - Org Name:CLEAR HEART COUNSELING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:MALKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:971-266-1693
Mailing Address - Street 1:1625 MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-6123
Mailing Address - Country:US
Mailing Address - Phone:971-266-1693
Mailing Address - Fax:503-387-3757
Practice Address - Street 1:1625 MEADOWS DR
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-6123
Practice Address - Country:US
Practice Address - Phone:971-266-1693
Practice Address - Fax:503-387-3757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-03
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR4845261QM0801X
261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)