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Organization

CHRISTIAN TREATMENT CENTER FOR ATTACHMENT TRAUMA AND SEXUAL ADD LLC

Active
Other names
The Four Rivers
Organization subpart
No

Provider details

NPI number
Authorized official
MS. HANNAH NICOLE FISCHER LPC,LMHC,MA (MENTAL HEALTH COUNSELOR/OWNER)
(503) 680-2478
Entity
Organization

Contact information

Practice address
9101 E BURNSIDE ST, PORTLAND, OR 97216-1515
(503) 680-2478
(360) 891-5511
Mailing address
3731 SE 164TH AVE, PORTLAND, OR 97236-1709
(503) 680-2478
(360) 891-5511

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C1901
OR
251S00000X
Community/Behavioral Health Agency
LH00010659
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1336313907
NPI # FOR HANNAH FISCHER COUNSELING INC
OR
Enumeration date
08/16/2010
Last updated
08/30/2010
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