Healthcare Provider Details

I. General information

NPI: 1568110203
Provider Name (Legal Business Name): ALIGN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6444 FAIRWAY AVE SE STE 100
SALEM OR
97306-3073
US

IV. Provider business mailing address

6015 BARCELONA DR SE
SALEM OR
97317-9383
US

V. Phone/Fax

Practice location:
  • Phone: 971-901-2731
  • Fax: 971-901-3065
Mailing address:
  • Phone: 971-218-7351
  • Fax: 971-901-3065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. MELISSA MARIE BRAVO
Title or Position: OWNER
Credential: LPC
Phone: 971-218-7351