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Organization

GREEN LIGHT COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HILLARY KAY PROVANCE-WHEELER LPC (OWNER)
(503) 877-3826
Entity
Organization

Contact information

Practice address
4744 LIBERTY RD S STE 20, SALEM, OR 97302-5181
(503) 877-3826
Mailing address
4848 FORSYTHE DR SE, SALEM, OR 97302-2195
(503) 949-9685

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
09/22/2022
Last updated
09/22/2022
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