Organization
OWLS NEST NORTH THERAPY JOINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI ERLICH LMFT (OWNER)
(503) 281-1166
Entity
Organization
Contact information
Practice address
3615 NE GRAND AVE, PORTLAND, OR 97212-2104
(503) 281-1166
(503) 281-0787
Mailing address
3615 NE GRAND AVE, PORTLAND, OR 97212-2104
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
T0691
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500643178 MCD
—
OR
Enumeration date
11/04/2014
Last updated
03/06/2024
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