Provider Demographics
NPI:1972044790
Name:BUILDING RESILIENCY LLC
Entity Type:Organization
Organization Name:BUILDING RESILIENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED LPC INTERN
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:STANG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CADC I, CCTP
Authorized Official - Phone:503-997-8863
Mailing Address - Street 1:2129 SE 176TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-5203
Mailing Address - Country:US
Mailing Address - Phone:503-997-8863
Mailing Address - Fax:
Practice Address - Street 1:510 NE ROBERTS AVE STE 310
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7485
Practice Address - Country:US
Practice Address - Phone:503-997-8863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR4360101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty