Healthcare Provider Details

I. General information

NPI: 1285507145
Provider Name (Legal Business Name): RICHARD THOMAS SEBENS LPC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 LOCKHAVEN DR NE
KEIZER OR
97303-2071
US

IV. Provider business mailing address

1740 SHAFF RD # 233
STAYTON OR
97383-1092
US

V. Phone/Fax

Practice location:
  • Phone: 503-851-8585
  • Fax:
Mailing address:
  • Phone: 503-851-8585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberR11994
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: