Provider Demographics
NPI:1649045261
Name:CLIMBING MOUNTAINS COUNSELING LLC
Entity type:Organization
Organization Name:CLIMBING MOUNTAINS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA IRMA
Authorized Official - Middle Name:IRMA
Authorized Official - Last Name:VERA GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CADCII
Authorized Official - Phone:503-866-4642
Mailing Address - Street 1:775 SW MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-1028
Mailing Address - Country:US
Mailing Address - Phone:503-866-4642
Mailing Address - Fax:
Practice Address - Street 1:775 SW MADISON ST
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-1028
Practice Address - Country:US
Practice Address - Phone:503-866-4642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty