Provider Demographics
NPI:1841852506
Name:AUCLAIR, SAMANTHA (MS, LPC, CRC, NCC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:AUCLAIR
Suffix:
Gender:F
Credentials:MS, LPC, CRC, NCC
Other - Prefix:
Other - First Name:SAMI
Other - Middle Name:
Other - Last Name:AUCLAIR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4531 SE BELMONT ST STE 320
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-1693
Mailing Address - Country:US
Mailing Address - Phone:503-738-1080
Mailing Address - Fax:503-664-7136
Practice Address - Street 1:4531 SE BELMONT ST STE 320
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1693
Practice Address - Country:US
Practice Address - Phone:503-738-1080
Practice Address - Fax:503-664-7136
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-02
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7117101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty