Healthcare Provider Details

I. General information

NPI: 1003697582
Provider Name (Legal Business Name): ALISON LAYTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. ALISON WADSWORTH

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3453 CLEARVIEW LN
AMMON ID
83406-4702
US

IV. Provider business mailing address

698 12TH ST SE STE 210
SALEM OR
97301-4010
US

V. Phone/Fax

Practice location:
  • Phone: 208-359-4840
  • Fax: 208-359-9010
Mailing address:
  • Phone: 503-383-1248
  • Fax: 503-217-6526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number101YM0800X
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1371766
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: