# MINDTREE HOLISTIC COUNSELING & WELLNESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MindTree
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922692995
- **Authorized official:** MS. SREEHARINI SUKUMARAN LMFT (OWNER / DIRECTOR)
- **Authorized official phone:** (503) 927-1656

## Contact information

- **Practice address:** 5440 SW WESTGATE DR STE 210, PORTLAND, OR 97221-2418
- **Practice address phone:** (503) 766-4895
- **Practice address fax:** (503) 716-4699
- **Mailing address:** 5440 SW WESTGATE DR STE 210, PORTLAND, OR 97221-2418
- **Mailing address phone:** (503) 766-4895
- **Mailing address fax:** (503) 716-4699

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2021
- **Last updated:** 03/29/2021