Provider Demographics
NPI:1366178394
Name:PACIFIC NORTHWEST COUNSELING & CONSULTATION LLC
Entity type:Organization
Organization Name:PACIFIC NORTHWEST COUNSELING & CONSULTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:971-373-4533
Mailing Address - Street 1:780 COMMERCIAL ST SE STE 201
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3463
Mailing Address - Country:US
Mailing Address - Phone:971-373-4533
Mailing Address - Fax:503-296-5997
Practice Address - Street 1:780 COMMERCIAL ST SE STE 201
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3463
Practice Address - Country:US
Practice Address - Phone:971-373-4533
Practice Address - Fax:503-296-5997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty