Healthcare Provider Details

I. General information

NPI: 1598772907
Provider Name (Legal Business Name): CRISTINA ZURITA CUEVAS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CRISTINA RAMIREZ LPC

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 MADISON ST NE STE F
SALEM OR
97301-7861
US

IV. Provider business mailing address

PO BOX 748465
ATLANTA GA
30374-8465
US

V. Phone/Fax

Practice location:
  • Phone: 971-253-7469
  • Fax:
Mailing address:
  • Phone: 855-284-7483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC2384
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: