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General NPI Number Information
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NPI Number | 1124113527
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Entity Type | Organization
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Legal Business Name | YOUTH CONTACT, INC
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 447 SE BASELINE ST
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City | HILLSBORO
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State | OR
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Zip | 97123-4103
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Country | US
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Telephone | 503-640-4222
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Fax | 503-640-0334
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Provider Business Mailing Address
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Address Line | 447 SE BASELINE ST
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City | HILLSBORO
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State | OR
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Zip | 97123-4103
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Country | US
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Telephone | 503-640-4222
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Fax | 503-640-0334
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JUDY R HARRIS
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Credential | MSW, LCSW
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Telephone | 503-640-4222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | OR
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