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General NPI Number Information
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NPI Number | 1215808993
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Entity Type | Organization
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Legal Business Name | DAISY COUNSELING LLC
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 11345 SE LEXINGTON ST
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City | PORTLAND
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State | OR
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Zip | 97266-5927
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Country | US
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Telephone | 503-908-3318
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Fax |
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Provider Business Mailing Address
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Address Line | 12042 SE SUNNYSIDE RD # 403
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City | CLACKAMAS
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State | OR
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Zip | 97015-8382
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Country | US
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Telephone | 503-908-3318
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | LAURA COLE FAIRBANKS
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Credential | LCSW
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Telephone | 503-908-3318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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