Healthcare Provider Details

I. General information

NPI: 1366046799
Provider Name (Legal Business Name): CAREWELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 11/25/2020
Certification Date: 11/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 SE SPOKANE ST STE 358
PORTLAND OR
97202-6494
US

IV. Provider business mailing address

205 SE SPOKANE ST STE 358
PORTLAND OR
97202-6494
US

V. Phone/Fax

Practice location:
  • Phone: 917-370-2358
  • Fax:
Mailing address:
  • Phone: 917-370-2358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JULIE BERMAN
Title or Position: OWNER
Credential: LPC
Phone: 917-370-2358