Organization
EPIPHANY COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH ANN ANDERSON (COMPLIANCE OFFICER)
(503) 999-9959
Entity
Organization
Contact information
Practice address
4905 SW SCHOLLS FERRY RD, PORTLAND, OR 97225-1605
(503) 889-0985
Mailing address
6312 SW CAPITOL HWY # 105, PORTLAND, OR 97239-1938
(503) 889-0985
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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