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General NPI Number Information
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NPI Number | 1942917034
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Entity Type | Organization
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Legal Business Name | WEST END COUNSELING ASSOCIATES, LLC
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Dates
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Enumeration Date | 10/31/2022
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 2031 HAWTHORNE ST STE C
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City | FOREST GROVE
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State | OR
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Zip | 97116-1700
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Country | US
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Telephone | 971-719-5703
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | FOREST GROVE
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State | OR
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Zip | 97116-0428
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Country | US
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Telephone | 971-719-5703
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | CHASITY MARYLAND
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Credential | LCSW
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Telephone | 337-565-0599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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