Provider Demographics
NPI:1851413405
Name:ASTRELLA, ALLISON ELEANOR (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:ELEANOR
Last Name:ASTRELLA
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 1:21210 NW MAUZEY RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-9327
Mailing Address - Country:US
Mailing Address - Phone:503-439-9531
Mailing Address - Fax:503-531-3841
Practice Address - Street 1:21210 NW MAUZEY RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9327
Practice Address - Country:US
Practice Address - Phone:503-439-9531
Practice Address - Fax:503-531-3841
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC3079101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR101YM0800XMedicaid
OR164936Medicaid