Healthcare Provider Details

I. General information

NPI: 1740410224
Provider Name (Legal Business Name): CENTER FOR ADDICTION AND COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 LANCASTER DR. NE
SALEM OR
97301
US

IV. Provider business mailing address

470 LANCASTER DR. NE
SALEM OR
97301
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 TaxonomyY
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 TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberC0492
License Number StateOR

VIII. Authorized Official

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