Provider Demographics
NPI:1932977501
Name:LILY OF THE VALLEY COUNSELING & COACHING SERVICES LLC
Entity Type:Organization
Organization Name:LILY OF THE VALLEY COUNSELING & COACHING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:971-331-9930
Mailing Address - Street 1:10457 NE 6TH DR APT 2303
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-1157
Mailing Address - Country:US
Mailing Address - Phone:971-331-9930
Mailing Address - Fax:
Practice Address - Street 1:819 SE MORRISON ST STE 245
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-6312
Practice Address - Country:US
Practice Address - Phone:971-978-6884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty