Provider Demographics
NPI:1811725534
Name:EAST TO WEST THERAPY LLC
Entity type:Organization
Organization Name:EAST TO WEST THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAUDOIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:413-687-1120
Mailing Address - Street 1:2523 35TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-1889
Mailing Address - Country:US
Mailing Address - Phone:413-687-1120
Mailing Address - Fax:
Practice Address - Street 1:2523 35TH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-1889
Practice Address - Country:US
Practice Address - Phone:413-687-1120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health