Provider Demographics
NPI:1629478961
Name:KELLEHER, ELEANOR (LPC)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:KELLEHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10315 NE TANASBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7836
Mailing Address - Country:US
Mailing Address - Phone:503-249-3434
Mailing Address - Fax:
Practice Address - Street 1:10315 NE TANASBOURNE DR
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7836
Practice Address - Country:US
Practice Address - Phone:503-729-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-22
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional