Healthcare Provider Details

I. General information

NPI: 1023691805
Provider Name (Legal Business Name): MANAR ABOUL-NOUR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1060 WEBBER ST
THE DALLES OR
97058-3749
US

IV. Provider business mailing address

1060 WEBBER ST
THE DALLES OR
97058-3749
US

V. Phone/Fax

Practice location:
  • Phone: 541-296-5452
  • Fax: 541-296-9418
Mailing address:
  • Phone: 541-296-5452
  • Fax: 541-296-5263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401225948
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451023437
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC7999
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: