Healthcare Provider Details

I. General information

NPI: 1962756627
Provider Name (Legal Business Name): BARBARA HAFDAHL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2012
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 NE 122ND AVE STE 102
PORTLAND OR
97230-1359
US

IV. Provider business mailing address

4110 NE 122ND AVE STE 102
PORTLAND OR
97230-1359
US

V. Phone/Fax

Practice location:
  • Phone: 503-260-8793
  • Fax: 971-231-2039
Mailing address:
  • Phone: 503-260-8793
  • Fax: 971-231-2039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC2996
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: