Provider Demographics
NPI:1801512488
Name:DIAN'S WELL COUNSELING LLC
Entity type:Organization
Organization Name:DIAN'S WELL COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPERATOR/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-383-9643
Mailing Address - Street 1:2410 SE 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4624
Mailing Address - Country:US
Mailing Address - Phone:503-383-9643
Mailing Address - Fax:503-214-5545
Practice Address - Street 1:2410 SE 10TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4624
Practice Address - Country:US
Practice Address - Phone:503-383-9643
Practice Address - Fax:503-214-5545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2024-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty