Individual
NICOLE VAN ALSTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC-R CRM, PSS
Contact information
Practice address
1059 NW MADRAS HWY, PRINEVILLE, OR 97754
(541) 323-5330
Mailing address
340 NW 5TH ST, REDMOND, OR 97756
(541) 504-2218
(541) 504-1195
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23-11-10947
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
TG-24-260
OR
101YM0800X
Mental Health Counselor
24-QMHA-1-004670
OR
175T00000X
Peer Specialist
20-CRM-019
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20-CRM-019
—
OR
Enumeration date
05/20/2021
Last updated
04/30/2025
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