Provider Demographics
NPI:1689298291
Name:UMBRELLA COUNSELING SERVICES
Entity Type:Organization
Organization Name:UMBRELLA COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:301-455-8528
Mailing Address - Street 1:5039 SW BRUGGER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5124
Mailing Address - Country:US
Mailing Address - Phone:301-455-8528
Mailing Address - Fax:
Practice Address - Street 1:7420 SW GARDEN HOME RD STE A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-9599
Practice Address - Country:US
Practice Address - Phone:503-946-6177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-31
Last Update Date:2020-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORT0889OtherMENTAL HEALTH COUNSELING