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NPI Code Detail

MEDICARE: TINA HADLEY LMFT

MEDICARE:   TINA  HADLEY  LMFT
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
1106H00000XMarriage & Family TherapistT0671OR
2101YM0800XMental Health Counselor
3101YA0400XAddiction (Substance Use Disorder) Counselor08-06-28OR

General Provider Information

NPI Number : 1922173947
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA HADLEY LMFT
Provider Business Mailing Address
First Line : 521 SW 11TH AVE
Second Line : 2ND FLOOR
City : PORTLAND
State : OR
Zip : 97205-2634
Country : US
Telephone Number : 503-944-1226
Fax Number : 503-224-6047
Provider Business Practice Location Address
First Line : 521 SW 11TH AVE
Second Line : 2ND FLOOR
City : PORTLAND
State : OR
Zip : 97205-2634
Country : US
Telephone Number : 503-944-1226
Fax Number : 503-224-6047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2006
Last Update Date : 12/17/2021

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Directions to “ TINA HADLEY LMFT” Practice Location

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