Individual
CECILIA B BRANDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II/QMHA-I
Contact information
Practice address
17645 NW SAINT HELENS RD, PORTLAND, OR 97231-1729
(503) 621-1069
(503) 621-0200
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22-05-20159
OR
101YM0800X
Mental Health Counselor
24-QMHA-I-004403
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500778251
—
OR
Enumeration date
04/22/2020
Last updated
06/28/2024
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