Provider Demographics
NPI:1922498914
Name:NW COUNSELING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NW COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VLIET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-869-4071
Mailing Address - Street 1:3000 NW STUCKI PL
Mailing Address - Street 2:ST 150
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7107
Mailing Address - Country:US
Mailing Address - Phone:503-869-4071
Mailing Address - Fax:503-295-4036
Practice Address - Street 1:3000 NW STUCKI PL
Practice Address - Street 2:ST 150
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7107
Practice Address - Country:US
Practice Address - Phone:503-869-4071
Practice Address - Fax:503-295-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2470261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health