=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942168810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTHERN STAR COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2026
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 189 LIBERTY ST NE STE 202D
-----------------------------------------------------
City | SALEM
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97301-3682
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-610-2542
-----------------------------------------------------
Fax | 503-610-5864
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5441 S MACADAM AVE STE A
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97239-3821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-610-2542
-----------------------------------------------------
Fax | 503-610-5864
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL SOCIAL WORKER/OWNER
-----------------------------------------------------
Name | ROBERT THOMAS HEINZ
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 503-610-2542
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------