Individual
JOHN ACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II, CGAC I,QMHA
Contact information
Practice address
3878 BEVERLY AVE NE, BLDG H, SUITE 5, SALEM, OR 97305-1394
(503) 399-0670
(503) 399-0655
Mailing address
3878 BEVERLY AVE NE, BLDG H, SUITE 5, SALEM, OR 97305-1394
(503) 399-0670
(503) 399-0655
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
G 16-04-01
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
12-06-75U
OR
101YM0800X
Mental Health Counselor
—
OR
Other
Enumeration date
04/25/2013
Last updated
05/26/2016
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