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General NPI Number Information
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NPI Number | 1255906558
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Entity Type | Individual
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Provider Name | NICOLE VAN ALSTINE CADC-R CRM, PSS
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Gender | Female
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 1059 NW MADRAS HWY
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City | PRINEVILLE
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State | OR
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Zip | 97754
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Country | US
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Telephone | 541-323-5330
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Fax |
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Provider Business Mailing Address
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Address Line | 340 NW 5TH ST
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City | REDMOND
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State | OR
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Zip | 97756
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Country | US
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Telephone | 541-504-2218
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Fax | 541-504-1195
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | TG-24-260
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License Number State | OR
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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 | 24-QMHA-1-004670
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | 20-CRM-019
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 23-11-10947
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License Number State | OR
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