| Corporate Consulting Group, Inc | |
|
11905 Sw 60th Ave Portland OR 97219-7005 | |
| (503) 226-0828 | |
| (503) 892-8281 |
| Full Name | Corporate Consulting Group, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 11905 Sw 60th Ave, Portland, Oregon |
| Authorized Official Name and Position | Birgitta Von Schlumperger (CEO/PRESIDENT/OWNER) |
| Authorized Official Contact | 5032260828 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corporate Consulting Group, Inc 11905 Sw 60th Ave Portland OR 97219-7005 Ph: (150) 322-6082 | Corporate Consulting Group, Inc 11905 Sw 60th Ave Portland OR 97219-7005 Ph: (503) 226-0828 |
| NPI Number | 1427585546 |
|---|---|
| Provider Enumeration Date | 05/19/2017 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 8123370780 |
|---|---|
| Medicare Enrollment ID | O20181009002067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427585546 | NPI | - | NPPES |
| 1578554671 | Other | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 736 (Oregon) | Primary |
| Provider Name | Birgitta Von Schlumperger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578554671 PECOS PAC ID: 5294087854 Enrollment ID: I20181009002246 |
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