Healthcare Provider Details
I. General information
NPI: 1609412535
Provider Name (Legal Business Name): EK COUNSELING CONSULTING AND TRAINING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/26/2019
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3525 HILYARD ST
EUGENE OR
97405-3866
US
IV. Provider business mailing address
PO BOX 71093
SPRINGFIELD OR
97475-0182
US
V. Phone/Fax
- Phone: 541-871-9050
- Fax:
- Phone: 541-871-9050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 500772657 |
| Identifier Type | MEDICAID |
| Identifier State | OR |
| Identifier Issuer | |
VIII. Authorized Official
Name:
ERIN
JEAN
WOLFF
Title or Position: OWNER/PROVIDER
Credential: LMFT
Phone: 541-871-9050