Healthcare Provider Details

I. General information

NPI: 1407768427
Provider Name (Legal Business Name): CENTER FOR ADDICTION AND COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 LANCASTER DR NE
SALEM OR
97301-4728
US

IV. Provider business mailing address

470 LANCASTER DR NE
SALEM OR
97301-4728
US

V. Phone/Fax

Practice location:
  • Phone: 503-584-1906
  • Fax: 503-584-1952
Mailing address:
  • Phone: 503-584-1906
  • Fax: 503-584-1952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ELIZABETH BOLAND
Title or Position: OWNER
Credential: LPC, NCC, CADC
Phone: 503-584-1906