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General NPI Number Information
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NPI Number | 1912696030
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Entity Type | Individual
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Provider Name | MICHAEL HENDRIX LPC-A
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Gender | Male
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Dates
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Enumeration Date | 05/04/2023
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 1738 SE 38TH AVE
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City | PORTLAND
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State | OR
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Zip | 97214-5250
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Country | US
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Telephone | 680-242-3299
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Fax |
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Provider Business Mailing Address
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Address Line | 1738 SE 38TH AVE
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City | PORTLAND
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State | OR
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Zip | 97214-5250
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Country | US
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Telephone | 680-242-3299
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | R11780
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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