Individual
FAYE L GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC II/QMHA-R
Contact information
Practice address
703 NE HANCOCK ST, PORTLAND, OR 97212-3955
(503) 230-9875
(503) 331-3441
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
98-04-59
OR
101YM0800X
Mental Health Counselor
22-QMHA-R-2048
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500739801
—
OR
05
—
500739807
—
OR
Enumeration date
01/29/2018
Last updated
11/04/2022
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