Provider Demographics
NPI:1255040739
Name:NORTH STAR COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:NORTH STAR COUNSELING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-241-4420
Mailing Address - Street 1:20005 VOLTERA PL
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3013
Mailing Address - Country:US
Mailing Address - Phone:541-241-4420
Mailing Address - Fax:541-610-1887
Practice Address - Street 1:695 SW MILL VIEW WAY STE 203
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1557
Practice Address - Country:US
Practice Address - Phone:541-241-4420
Practice Address - Fax:541-508-4528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH STAR COUNSELING SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-23
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500767099Medicaid