Healthcare Provider Details

I. General information

NPI: 1366907693
Provider Name (Legal Business Name): HORIZONS PROFESSIONAL COUNSELING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2019
Last Update Date: 01/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 GATEWAY LOOP SUITE 118
SPRINGFIELD OR
97477
US

IV. Provider business mailing address

1126 GATEWAY LOOP SUITE 118
SPRINGFIELD OR
97477
US

V. Phone/Fax

Practice location:
  • Phone: 541-525-0673
  • Fax: 541-982-2275
Mailing address:
  • Phone: 541-525-0673
  • Fax: 541-982-2275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MS. KARLENE HOWIE
Title or Position: DIRECTOR
Credential: MS, LPC, CADC
Phone: 541-525-0673