Healthcare Provider Details

I. General information

NPI: 1972398089
Provider Name (Legal Business Name): MINDPEACE MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4531 SE BELMONT ST STE 114
PORTLAND OR
97215-1675
US

IV. Provider business mailing address

4531 SE BELMONT ST STE 114
PORTLAND OR
97215-1675
US

V. Phone/Fax

Practice location:
  • Phone: 971-365-3621
  • Fax: 949-703-7718
Mailing address:
  • Phone: 971-365-3621
  • Fax: 971-703-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTINE H HABOUSH
Title or Position: OWNER AND CLINICIAN
Credential: PMHNP
Phone: 971-365-3621