# QUEER EXPRESSIONS MENTAL HEALTH COLLECTIVE: INDIVIDUAL & FAMILY COUNSE

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

## Provider details

- **NPI number:** 1427780212
- **Authorized official:** LEE LYNCH LMFT (AGENT)
- **Authorized official phone:** (510) 680-3545

## Contact information

- **Practice address:** 1923 NE BROADWAY ST UNIT 5, PORTLAND, OR 97232-1501
- **Practice address phone:** (503) 908-9435
- **Mailing address:** 1923 NE BROADWAY ST UNIT 5, PORTLAND, OR 97232-1501
- **Mailing address phone:** (503) 908-9435

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2022
- **Last updated:** 08/30/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1245590884 | INDIVIDUAL | CA |
| 01 | — | 1376956086 | INDIVIDUAL | CA |