Provider Demographics
NPI:1366208522
Name:EMBODYMENT COUNSELING
Entity type:Organization
Organization Name:EMBODYMENT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:EMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:VON LETKEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:971-260-3475
Mailing Address - Street 1:1020 SW TAYLOR ST STE 660
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2559
Mailing Address - Country:US
Mailing Address - Phone:971-260-3475
Mailing Address - Fax:971-277-7695
Practice Address - Street 1:1020 SW TAYLOR ST STE 660
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2559
Practice Address - Country:US
Practice Address - Phone:971-260-3475
Practice Address - Fax:971-277-7695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty