Healthcare Provider Details

I. General information

NPI: 1912844176
Provider Name (Legal Business Name): WHOLISTIC COUNSELING & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82887 MINNICK RD
DEXTER OR
97431-9606
US

IV. Provider business mailing address

82887 MINNICK RD
DEXTER OR
97431-9606
US

V. Phone/Fax

Practice location:
  • Phone: 541-321-0066
  • Fax:
Mailing address:
  • Phone: 541-321-0066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHELSIE MAEGAN HUGO
Title or Position: LPC
Credential: M.A., LPC, PMH-C
Phone: 541-321-0066