Provider Demographics
NPI:1700551413
Name:BIRCH WOODS COUNSELING LLC
Entity Type:Organization
Organization Name:BIRCH WOODS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LUTZKE-HOFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-292-7205
Mailing Address - Street 1:6901 SE LAKE RD STE 27
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97267-2195
Mailing Address - Country:US
Mailing Address - Phone:971-246-4665
Mailing Address - Fax:
Practice Address - Street 1:6901 SE LAKE RD STE 27
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-2195
Practice Address - Country:US
Practice Address - Phone:971-246-4665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health