Provider Demographics
NPI:1295328821
Name:REVOLUTION COUNSELING, LLC
Entity type:Organization
Organization Name:REVOLUTION COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJABEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHRAF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:541-286-5207
Mailing Address - Street 1:2373 NW 185TH AVE # 635
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7076
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1915 NE STUCKI AVE STE 308
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97006-6951
Practice Address - Country:US
Practice Address - Phone:541-286-5207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty