Individual
CORIE FERESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CADCII, LPC
Contact information
Practice address
1507 NE 122ND AVE, PORTLAND, OR 97230
(503) 258-4381
Mailing address
11035 NE SANDY BLVD, PORTLAND, OR 97220-2553
(503) 258-4381
(503) 493-2656
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15-10-23
OR
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C5304
OR
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
05/15/2013
Last updated
08/01/2022
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