MEDICARE: HYB COUNSELING

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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1497489991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HYB COUNSELING

Provider Business Mailing Address
First Line	:	PO BOX 20611
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97307-0611
Country	:	US
Telephone Number	:	503-504-2103
Fax Number	:	503-386-3273

Provider Business Practice Location Address
First Line	:	2405 FRONT ST NE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97301-0775
Country	:	US
Telephone Number	:	503-504-2103
Fax Number	:	503-386-3273

Authorized Official
Title or Position	:	OWNER / PROVIDER
Name	:	MR. SONNY SALTALAMACHIA
Credential	:	LPC
Telephone Number	:	503-507-1019

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	07/12/2022

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Directions to “HYB COUNSELING ” Practice Location

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