Provider Demographics
NPI:1902373541
Name:BROOKHOUSE, VANESSA D (LPC)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:D
Last Name:BROOKHOUSE
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 1:22518 S PARROT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-9725
Mailing Address - Country:US
Mailing Address - Phone:503-266-3050
Mailing Address - Fax:503-266-4793
Practice Address - Street 1:2104 SE MORRISON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2825
Practice Address - Country:US
Practice Address - Phone:503-908-4451
Practice Address - Fax:503-266-4793
Is Sole Proprietor?:No
Enumeration Date:2018-11-01
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5407101YM0800X
ORR4756101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health