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Individual

MISS CAMILLE ELISA ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
4856 NE PRESCOTT ST, PORTLAND, OR 97218-1751
(662) 321-1448
Mailing address
4856 NE PRESCOTT ST, PORTLAND, OR 97218-1751
(662) 321-1448

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
14862
NC
101Y00000X
Counselor
2162
MS
101Y00000X
Counselor
8008
TN
101Y00000X
Counselor
C8053
OR
101Y00000X
Counselor
TPMC4949
FL
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
C8053
OR

Other

Enumeration date
08/09/2013
Last updated
10/10/2025
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