MEDICARE: NEUROHAVEN COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1033916523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEUROHAVEN COUNSELING LLC

Provider Business Mailing Address
First Line	:	808 SE CHKALOV DR
Second Line	:	STE 3 - 402
City	:	VANCOUVER
State	:	WA
Zip	:	98683
Country	:	US
Telephone Number	:	541-971-6020
Fax Number	:

Provider Business Practice Location Address
First Line	:	17562 BLUE HERON CT
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-6602
Country	:	US
Telephone Number	:	541-971-6020
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PSYCHOTHERAPIST
Name	:	ALEXANDRIA PATTON
Credential	:	LPC, MT-BC
Telephone Number	:	541-971-6020

Provider Enumeration Date	:	03/03/2025
Last Update Date	:	03/03/2025

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