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General NPI Number Information
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NPI Number | 1144811936
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Entity Type | Organization
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Legal Business Name | ALLY COUNSELING, LLC
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Dates
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Enumeration Date | 02/03/2021
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 5655 SOUTHWOOD DR
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-6733
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Country | US
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Telephone | 503-208-4327
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Fax |
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Provider Business Mailing Address
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Address Line | 15875 BOONES FERRY RD UNIT 1254
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City | LAKE GROVE
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State | OR
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Zip | 97035
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Country | US
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Telephone | 503-208-4635
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Fax | 971-369-9854
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. BRETT EDMOND JOHNSON
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Credential | LMFT
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Telephone | 503-208-4635
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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