Provider Demographics
NPI:1760981534
Name:OSTERGREN COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:OSTERGREN COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:YUNGEN
Authorized Official - Last Name:OSTERGREN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-348-2125
Mailing Address - Street 1:1255 HANSEN AVE S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4062
Mailing Address - Country:US
Mailing Address - Phone:503-348-2125
Mailing Address - Fax:
Practice Address - Street 1:388 STATE ST STE 810
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3470
Practice Address - Country:US
Practice Address - Phone:503-348-2125
Practice Address - Fax:503-348-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3559101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty