Healthcare Provider Details

I. General information

NPI: 1699377648
Provider Name (Legal Business Name): VANCOUVER COUNSELING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 09/23/2022
Certification Date: 09/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15383 S GRAVES RD
MULINO OR
97042-9789
US

IV. Provider business mailing address

15383 S GRAVES RD
MULINO OR
97042-9789
US

V. Phone/Fax

Practice location:
  • Phone: 360-727-1450
  • Fax:
Mailing address:
  • Phone: 360-727-1450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KELSEY SOMPPI
Title or Position: OWNER/ THERAPIST
Credential: LMFT
Phone: 360-727-1450