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Individual

JANICE CONSTANTINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, CADC 1

Contact information

Practice address
1841 SW MERLO DR, BEAVERTON, OR 97003-5013
(503) 941-3210
Mailing address
7320 SW HUNZIKER RD STE 300, PORTLAND, OR 97223-2302
(503) 941-3033

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
Primary
C5387
OR
372600000X
Adult Companion

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500697420
OR
Enumeration date
01/05/2015
Last updated
09/24/2021
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