# NORTHSIDE FAMILY COUNSELING, INC

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

## Provider details

- **NPI number:** 1871658997
- **Authorized official:** CHARLES E RAHE LCSW (DIRECTOR)
- **Authorized official phone:** (503) 543-6164

## Contact information

- **Practice address:** 51579 COLUMBIA RIVER HWY, STE 'I', SCAPPOOSE, OR 97056-8411
- **Practice address phone:** (503) 543-6164
- **Practice address fax:** (503) 543-6040
- **Mailing address:** 51579 COLUMBIA RIVER HWY, STE 'I', SCAPPOOSE, OR 97056-8411
- **Mailing address phone:** (503) 543-6164
- **Mailing address fax:** (503) 543-6040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | L1330 | OR | Yes |
| 1041C0700X | Clinical Social Worker | L2799 | OR | — |
| 106H00000X | Marriage & Family Therapist | T0349 | OR | — |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 11/09/2009