Provider Demographics
NPI:1336623602
Name:VISTAS COUNSELING, LLC
Entity Type:Organization
Organization Name:VISTAS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:YEREX
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:971-226-4040
Mailing Address - Street 1:123 E POWELL BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-7622
Mailing Address - Country:US
Mailing Address - Phone:971-777-3272
Mailing Address - Fax:844-364-1335
Practice Address - Street 1:123 E POWELL BLVD STE 212
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7622
Practice Address - Country:US
Practice Address - Phone:971-777-3272
Practice Address - Fax:844-364-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-21
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty