Healthcare Provider Details

I. General information

NPI: 1770430431
Provider Name (Legal Business Name): TAKE THE REINS COUNSELING AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 NE 2ND ST
GRESHAM OR
97030-7512
US

IV. Provider business mailing address

PO BOX 955
GRESHAM OR
97030-0210
US

V. Phone/Fax

Practice location:
  • Phone: 971-373-6486
  • Fax: 503-661-1033
Mailing address:
  • Phone: 971-373-6486
  • Fax: 503-661-1033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENETTE MUNDLIN
Title or Position: OWNER
Credential: LPC
Phone: 971-373-6486