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General NPI Number Information
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NPI Number | 1700551413
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Entity Type | Organization
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Legal Business Name | BIRCH WOODS COUNSELING LLC
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 6901 SE LAKE RD STE 27
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City | MILWAUKIE
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State | OR
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Zip | 97267-2195
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Country | US
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Telephone | 971-246-4665
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Fax |
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Provider Business Mailing Address
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Address Line | 6901 SE LAKE RD STE 27
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City | MILWAUKIE
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State | OR
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Zip | 97267-2195
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Country | US
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Telephone | 971-246-4665
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | MS. SUSAN MARIE LUTZKE-HOFF
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Credential | LCSW
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Telephone | 541-292-7205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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