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General NPI Number Information
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NPI Number | 1255495719
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Entity Type | Organization
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Legal Business Name | ALLIANCE COUNSELING CENTER, INC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 22018 S CENTRAL POINT RD SUITE #3
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City | CANBY
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State | OR
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Zip | 97013-8705
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Country | US
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Telephone | 503-412-8149
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Fax | 503-263-6278
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Provider Business Mailing Address
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Address Line | 22018 S CENTRAL POINT RD SUITE #3
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City | CANBY
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State | OR
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Zip | 97013-8705
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Country | US
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Telephone | 503-412-8149
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Fax | 503-263-6278
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JOYCE KORSCHGEN
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Credential | LPC
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Telephone | 503-221-4531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C0741
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License Number State | OR
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