Individual
KELSEY BRENNA MOVCHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS, CRM, QMHA-R
Contact information
Practice address
3636 NE BROADWAY ST, PORTLAND, OR 97232-1823
(503) 548-0346
(503) 621-0200
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(971) 217-9008
(971) 260-0355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
25-CRM-4213
OR
101YM0800X
Mental Health Counselor
25-QMHA-R-7290
OR
101YM0800X
Mental Health Counselor
Primary
—
—
175T00000X
Peer Specialist
Primary
111927
OR
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/07/2024
Last updated
04/27/2026
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