Provider Demographics
NPI:1972624500
Name:SUNSET PSYCHOLOGICAL & COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:SUNSET PSYCHOLOGICAL & COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CHIMENTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-292-1885
Mailing Address - Street 1:9900 SW WILSHIRE ST., SUITE 230
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225
Mailing Address - Country:US
Mailing Address - Phone:503-292-1885
Mailing Address - Fax:503-292-1787
Practice Address - Street 1:9900 SW WILSHIRE ST STE 230
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5043
Practice Address - Country:US
Practice Address - Phone:503-292-1885
Practice Address - Fax:503-292-1787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3639251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health