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NPI Code Detail

MEDICARE: LYSETTE HERRERA LMHC, LPC

MEDICARE: LYSETTE HERRERA LMHC, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLH60401264WA
2101YM0800XMental Health Counselor004125NY
3101YP2500XProfessional CounselorC3246OR

General Provider Information

NPI Number : 1134312697
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYSETTE HERRERA LMHC, LPC
Provider Business Mailing Address
First Line : 18765 SW BOONES FERRY RD STE 100
Second Line :
City : TUALATIN
State : OR
Zip : 97062-8607
Country : US
Telephone Number : 503-612-1000
Fax Number : 503-612-1090
Provider Business Practice Location Address
First Line : 18765 SW BOONES FERRY RD STE 100
Second Line :
City : TUALATIN
State : OR
Zip : 97062-8607
Country : US
Telephone Number : 503-612-1000
Fax Number : 503-612-1090
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2007
Last Update Date : 10/07/2019

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