Healthcare Provider Details

I. General information

NPI: 1922365832
Provider Name (Legal Business Name): P & P THERAPEUTIC COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 04/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 WILLAMETTE ST SUITE 306
EUGENE OR
97401-2952
US

IV. Provider business mailing address

767 WILLAMETTE ST SUITE 306
EUGENE OR
97401-2952
US

V. Phone/Fax

Practice location:
  • Phone: 541-485-1167
  • Fax:
Mailing address:
  • Phone: 541-485-1167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PORSHEA PENDLETON
Title or Position: PRESIDENT
Credential: LMFT
Phone: 541-485-1167