Healthcare Provider Details

I. General information

NPI: 1841855186
Provider Name (Legal Business Name): COLUMBIA COMMUNITY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 S 1ST ST
SAINT HELENS OR
97051-2003
US

IV. Provider business mailing address

58646 MCNULTY WAY
SAINT HELENS OR
97051-6210
US

V. Phone/Fax

Practice location:
  • Phone: 503-410-5156
  • Fax: 503-397-5373
Mailing address:
  • Phone: 503-397-5211
  • Fax: 503-397-5373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TODD JACOBSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 503-397-5211