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General NPI Number Information
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NPI Number | 1386389740
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Entity Type | Organization
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Legal Business Name | MINDFULNESS COUNSELING LLC
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Dates
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Enumeration Date | 04/30/2022
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 10700 SW BEAVERTON HILLSDALE HWY STE 560
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City | BEAVERTON
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State | OR
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Zip | 97005-4791
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Country | US
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Telephone | 503-208-6511
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Fax |
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Provider Business Mailing Address
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Address Line | 12725 SW MILLIKAN WAY STE 300
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City | BEAVERTON
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State | OR
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Zip | 97005-1687
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Country | US
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Telephone | 503-758-9185
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | KELLY KATHLEEN SESTERO
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Credential | LPC, LMHC, NCC
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Telephone | 503-208-6511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 |
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