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General NPI Number Information
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NPI Number | 1487241436
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Entity Type | Organization
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Legal Business Name | UNIQUELY YOU COUNSELING LLC
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Dates
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Enumeration Date | 12/23/2020
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 4424 NE GLISAN ST
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City | PORTLAND
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State | OR
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Zip | 97213-2331
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Country | US
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Telephone | 971-266-4102
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Fax |
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Provider Business Mailing Address
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Address Line | 2816 NE 121ST AVE
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City | PORTLAND
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State | OR
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Zip | 97220-1731
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA REDEAU
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Credential | LPC, CADC
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Telephone | 503-998-5613
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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 | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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