Organization
CREEKSIDE COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L LAHARTY MS CDS III (CEO)
(503) 371-4160
Entity
Organization
Contact information
Practice address
2586 12TH PLACE SE, SALEM, OR 97302
(503) 371-4160
(503) 375-9727
Mailing address
PO BOX 4169, SALEM, OR 97302
(503) 371-4160
(503) 375-9727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/05/2007
Last updated
08/22/2020
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