Healthcare Provider Details

I. General information

NPI: 1255571634
Provider Name (Legal Business Name): LINDA MARIE STENBERG MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 12/20/2019
Certification Date: 12/20/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8855 SW HOLLY LN STE 131
WILSONVILLE OR
97070-8793
US

IV. Provider business mailing address

27751 S KLINGER RD
CANBY OR
97013-9344
US

V. Phone/Fax

Practice location:
  • Phone: 503-673-6900
  • Fax:
Mailing address:
  • Phone: 503-266-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC1220
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: