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General NPI Number Information
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NPI Number | 1619379898
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Entity Type | Organization
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Legal Business Name | PIVOT POINTE COUNSELING CENTER
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 11818 SE MILL PLAIN BLVD. SUITE 213
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City | VANCOUVER
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State | WA
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Zip | 98684-5091
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Country | US
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Telephone | 360-836-4386
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Fax |
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Provider Business Mailing Address
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Address Line | 11818 SE MILL PLAIN BLVD. SUITE 213
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City | VANCOUVER
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State | WA
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Zip | 98684-5091
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Country | US
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Telephone | 360-836-4386
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Fax |
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Authorized Official
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Title or Position | OWNER/MENTAL HEALTH COUNSELOR ASSOC
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Name | MRS. PORTIA E JONES
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Credential | MA
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Telephone | 360-836-4386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MC60395991
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License Number State | WA
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