Healthcare Provider Details

I. General information

NPI: 1225422975
Provider Name (Legal Business Name): CELINE ELISE REDFIELD MA., LMFT, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CELINE ALAVREZ LMFT

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 NE BROADWAY ST. STE #6
PORTLAND OR
97232-1501
US

IV. Provider business mailing address

PO BOX 12382
PORTLAND OR
97212
US

V. Phone/Fax

Practice location:
  • Phone: 971-284-0063
  • Fax: 833-523-2431
Mailing address:
  • Phone: 917-248-0063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number83984
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number13-270
License Number State
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberORART-T-10205997
License Number StateOR
# 4
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT1386
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: