Healthcare Provider Details

I. General information

NPI: 1215403449
Provider Name (Legal Business Name): CATHERINE JONES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 10/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 N MAIN AVE STE 201C
GRESHAM OR
97030-7242
US

IV. Provider business mailing address

10955 SW BRIARWOOD PL
TIGARD OR
97223-1954
US

V. Phone/Fax

Practice location:
  • Phone: 503-347-7575
  • Fax:
Mailing address:
  • Phone: 847-334-1258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
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: CATHERINE JONES
Title or Position: OWNER/THERAPIST
Credential: LPC, ATR
Phone: 503-347-7575