Provider Demographics
NPI:1790206837
Name:SARABETH CASEY COUNSELING
Entity Type:Organization
Organization Name:SARABETH CASEY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-869-3813
Mailing Address - Street 1:8555 SW APPLE WAY STE 320
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1775
Mailing Address - Country:US
Mailing Address - Phone:503-869-3813
Mailing Address - Fax:
Practice Address - Street 1:8555 SW APPLE WAY
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1774
Practice Address - Country:US
Practice Address - Phone:503-869-3813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2350261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health