Provider Demographics
NPI:1669883054
Name:ROY HUGGINS
Entity type:Organization
Organization Name:ROY HUGGINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRET
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-839-4825
Mailing Address - Street 1:3212 SE 9TH AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-2544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:511 SW 10TH AVE STE 614
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2707
Practice Address - Country:US
Practice Address - Phone:503-839-4825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty