Organization
WESTERN PSYCHOLOGICAL AND COUNSELING SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA ROBERTSON (CONTRACT AND CREDENTIALING)
(503) 233-5405
Entity
Organization
Contact information
Practice address
2222 E POWELL BLVD, GRESHAM, OR 97080-1365
(503) 669-4300
(503) 669-4301
Mailing address
PO BOX 82819, PORTLAND, OR 97282
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
03/27/2017
Last updated
01/26/2018
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