# RADICAL HEALING PSYCHOTHERAPY, LLC

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

## Provider details

- **NPI number:** 1710868443
- **Authorized official:** MARILYN STEPHENS LCSW (OWNER)
- **Authorized official phone:** (971) 330-0612

## Contact information

- **Practice address:** 5020 NE MARTIN LUTHER KING BLVD, PORTLAND, OR 97211-3204
- **Practice address phone:** (971) 330-0612
- **Mailing address:** 15200 SW SPARROW LOOP UNIT 102, BEAVERTON, OR 97007-9358
- **Mailing address phone:** (971) 330-0612

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 09/09/2025
- **Last updated:** 09/09/2025