Organization
DIRKSE COUNSELING AND CONSULTING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW LUNDGREN (CLINICAL SUPERVISOR)
(503) 430-5762
Entity
Organization
Contact information
Practice address
9725 SW BEAVERTON HILLSDALE HWY STE 230, BEAVERTON, OR 97005-4755
(503) 430-5762
(503) 672-7668
Mailing address
9725 SW BEAVERTON HILLSDALE HWY STE 230, BEAVERTON, OR 97005-4755
(503) 430-5762
(503) 672-7668
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500769429
—
OR
Enumeration date
02/28/2019
Last updated
04/22/2024
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