Organization
CAROLYN WATERFALL MS LPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN WATERFALL LPC (OWNER/COUNSELOR)
(503) 686-3918
Entity
Organization
Contact information
Practice address
704 MAIN ST STE 305-8, OREGON CITY, OR 97045-9704
(503) 686-3918
(503) 624-6352
Mailing address
12332 SW 72ND AVE STE 113, PORTLAND, OR 97223
(503) 686-3918
(503) 624-6352
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
12/20/2021
Last updated
12/21/2021
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