Healthcare Provider Details

I. General information

NPI: 1073271573
Provider Name (Legal Business Name): ANCORA COUNSELING AND THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2021
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 NE LINCOLN ST
HILLSBORO OR
97124-3066
US

IV. Provider business mailing address

239 NE LINCOLN ST
HILLSBORO OR
97124-3066
US

V. Phone/Fax

Practice location:
  • Phone: 971-238-4408
  • Fax:
Mailing address:
  • Phone: 971-238-4408
  • Fax:

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 Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KARA KAZEMBA
Title or Position: OWNER
Credential: LCSW
Phone: 971-238-4408