Provider Demographics
NPI:1982154498
Name:QUARTER-LIFE COUNSELING
Entity Type:Organization
Organization Name:QUARTER-LIFE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SATYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:503-349-4242
Mailing Address - Street 1:1017 SW MORRISON ST STE 407
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2629
Mailing Address - Country:US
Mailing Address - Phone:503-349-4242
Mailing Address - Fax:
Practice Address - Street 1:1017 SW MORRISON ST STE 407
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2629
Practice Address - Country:US
Practice Address - Phone:503-349-4242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3764101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty