Individual
STEPHANIE KAY KOUTSOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CADC-I, LPC, NCC
Contact information
Practice address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
(541) 322-7565
Mailing address
2577 NE COURTNEY DR, BEND, OR 97701-7638
(541) 322-7500
(541) 322-7565
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13-06-37
OR
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C3453
OR
Other
Enumeration date
10/14/2010
Last updated
07/10/2014
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