Individual
MRS. ELISSA L STARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,CADCI, LPC, NCC
Contact information
Practice address
5228 NE HOYT ST, PORTLAND, OR 97213-3055
(503) 215-2584
Mailing address
5228 NE HOYT ST, PORTLAND, OR 97213-3055
(503) 215-2584
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
274873
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-12-40
OR
101YM0800X
Mental Health Counselor
LH60889395
WA
101YP2500X
Professional Counselor
C5348
OR
Other
Enumeration date
03/03/2016
Last updated
12/17/2021
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