# PURE LIFE COUNSELING, LLC

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

## Provider details

- **NPI number:** 1982489951
- **Authorized official:** BENJAMIN FENNIMORE LCSW (MENTAL HEALTH CLINICIAN)
- **Authorized official phone:** (503) 428-2948

## Contact information

- **Practice address:** 494 STATE ST STE 270, SALEM, OR 97301-3647
- **Practice address phone:** (503) 583-2121
- **Mailing address:** 2860 WINTER ST SE, SALEM, OR 97302-3155
- **Mailing address phone:** (503) 428-2948

## Taxonomy

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

## Other

- **Enumeration date:** 08/29/2023
- **Last updated:** 08/29/2023