Provider Demographics
NPI:1689272379
Name:ONE WITH LIFE COUNSELING, PLLC
Entity Type:Organization
Organization Name:ONE WITH LIFE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:OLIVER
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:IV
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:503-791-4368
Mailing Address - Street 1:PO BOX 1109
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:WA
Mailing Address - Zip Code:98631-1109
Mailing Address - Country:US
Mailing Address - Phone:503-791-4368
Mailing Address - Fax:
Practice Address - Street 1:115 OREGON AVE S
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:WA
Practice Address - Zip Code:98631
Practice Address - Country:US
Practice Address - Phone:503-791-4368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty