Provider Demographics
NPI:1982383758
Name:PORTAL COUNSELING SERVICES
Entity Type:Organization
Organization Name:PORTAL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:LAURREN
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:971-202-1091
Mailing Address - Street 1:10000 NE 7TH AVE STE 410D
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98685-4599
Mailing Address - Country:US
Mailing Address - Phone:971-202-1091
Mailing Address - Fax:
Practice Address - Street 1:10000 NE 7TH AVE STE 410D
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4599
Practice Address - Country:US
Practice Address - Phone:971-202-1091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)