Healthcare Provider Details

I. General information

NPI: 1619304821
Provider Name (Legal Business Name): MINDY LAFRAMBOISE MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 08/29/2023
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 E POWELL BLVD STE 212
GRESHAM OR
97030-7622
US

IV. Provider business mailing address

123 E POWELL BLVD STE 212
GRESHAM OR
97030-7622
US

V. Phone/Fax

Practice location:
  • Phone: 503-328-8715
  • Fax: 503-328-8764
Mailing address:
  • Phone: 503-328-8715
  • Fax: 503-328-8764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC2823
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: