Healthcare Provider Details

I. General information

NPI: 1902455207
Provider Name (Legal Business Name): ALBATROSS COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 SW GRIFFITH DR STE 273
BEAVERTON OR
97005-5607
US

IV. Provider business mailing address

PO BOX 91323
PORTLAND OR
97291-0006
US

V. Phone/Fax

Practice location:
  • Phone: 971-239-4087
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRIS SCHEIFF
Title or Position: PRINCIPAL
Credential:
Phone: 971-239-4087