Healthcare Provider Details

I. General information

NPI: 1245254754
Provider Name (Legal Business Name): ERIN MENCZER LPC, CADC 1
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 NW CIVIC DR. SUITE 310
GRESHAM OR
97030
US

IV. Provider business mailing address

1700 NW CIVIC DR. SUITE 310
GRESHAM OR
97030
US

V. Phone/Fax

Practice location:
  • Phone: 503-666-8832
  • Fax: 503-669-8641
Mailing address:
  • Phone: 503-666-8832
  • Fax: 503-669-8641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC2428
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: