Provider Demographics
NPI:1174390124
Name:SYNERGY MENTAL HEALTH LLC
Entity type:Organization
Organization Name:SYNERGY MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:ALAINE
Authorized Official - Last Name:MCCLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-586-4852
Mailing Address - Street 1:7547 9TH CT SE
Mailing Address - Street 2:
Mailing Address - City:TURNER
Mailing Address - State:OR
Mailing Address - Zip Code:97392-9419
Mailing Address - Country:US
Mailing Address - Phone:503-586-4852
Mailing Address - Fax:503-689-8093
Practice Address - Street 1:7465 3RD ST SE
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:OR
Practice Address - Zip Code:97392-9704
Practice Address - Country:US
Practice Address - Phone:503-447-3633
Practice Address - Fax:503-689-8093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)