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General NPI Number Information
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NPI Number | 1699133348
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Entity Type | Organization
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Legal Business Name | SARAH WILSON COUNSELING
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 02/09/2016
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Provider Practice Location Address
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Address Line | 1135 SE SALMON ST UNIT 101
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City | PORTLAND
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State | OR
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Zip | 97214-3375
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Country | US
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Telephone | 503-729-2920
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Fax |
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Provider Business Mailing Address
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Address Line | 1135 SOUTHEAST SALMON STREET UNIT 101
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City | PORTLAND
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State | OR
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Zip | 97214
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Country | US
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Telephone | 503-729-2920
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Fax |
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Authorized Official
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Title or Position | CHILD, ADULT AND FAMILY THERAPIST
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Name | SARAH CATHERINE WILSON
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Credential | LPC
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Telephone | 503-729-2920
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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 | C3951
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | C3951
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License Number State | OR
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