Individual
NICOLE FELLENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, ATR
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
1306 NW HOYT ST STE 407, PORTLAND, OR 97209-2787
(971) 407-3930
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C6958
OR
Other
Enumeration date
08/21/2018
Last updated
09/17/2024
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