Healthcare Provider Details

I. General information

NPI: 1205472040
Provider Name (Legal Business Name): ELIZABETH SCHEELER COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 SW FRAZER AVE STE 111
PENDLETON OR
97801-2800
US

IV. Provider business mailing address

43395 HEAVENS LN
PENDLETON OR
97801-9490
US

V. Phone/Fax

Practice location:
  • Phone: 541-215-4557
  • Fax:
Mailing address:
  • Phone: 541-969-9195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELIZABETH SCHEELER
Title or Position: OWNER
Credential: LCSW
Phone: 541-215-4557