MEDICARE: REFLECTIONS COUNSELING LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831548460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFLECTIONS COUNSELING LLC

Provider Business Mailing Address
First Line	:	422 SE 79TH AVE STE 204
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97215-1519
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	422 SE 79TH AVE STE 204
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97215-1519
Country	:	US
Telephone Number	:	503-893-8843
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GALEN COHEN
Credential	:
Telephone Number	:	503-893-8843

Provider Enumeration Date	:	06/04/2016
Last Update Date	:	06/04/2016

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Directions to “REFLECTIONS COUNSELING LLC ” Practice Location

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