# EASTSIDE CHILD AND FAMILY THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366189797
- **Authorized official:** SARAH MANLUPIG LPC (OWNER/COUNSELOR)
- **Authorized official phone:** (503) 389-0542

## Contact information

- **Practice address:** 320 N MAIN AVE STE 201A, GRESHAM, OR 97030-7242
- **Practice address phone:** (503) 389-0542
- **Practice address fax:** (503) 405-4239
- **Mailing address:** 320 N MAIN AVE STE 201A, GRESHAM, OR 97030-7242
- **Mailing address phone:** (503) 389-0542
- **Mailing address fax:** (503) 405-4239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/17/2022
- **Last updated:** 05/17/2022