Healthcare Provider Details

I. General information

NPI: 1336028216
Provider Name (Legal Business Name): COURAGE TO CHANGE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 KLAMATH AVE
KLAMATH FALLS OR
97601-6109
US

IV. Provider business mailing address

2206 WASHBURN WAY # 1005
KLAMATH FALLS OR
97603-4508
US

V. Phone/Fax

Practice location:
  • Phone: 310-872-7591
  • Fax: 855-538-0564
Mailing address:
  • Phone: 310-872-7591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MARENA HUGHES
Title or Position: OWNER
Credential: LMFT
Phone: 310-872-7591