| Crispin Counseling Llc | |
|
8995 Sw Miley Rd Ste 103 Wilsonville OR 97070-5485 | |
| (503) 951-7990 | |
| (503) 785-9993 |
| Full Name | Crispin Counseling Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8995 Sw Miley Rd Ste 103, Wilsonville, Oregon |
| Authorized Official Name and Position | Heidi Lynn Crispin (COUNSELOR) |
| Authorized Official Contact | 5039517990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crispin Counseling Llc 24935 Ne Prairie View Dr Aurora OR 97002-9547 Ph: (503) 951-7990 | Crispin Counseling Llc 8995 Sw Miley Rd Ste 103 Wilsonville OR 97070-5485 Ph: (503) 951-7990 |
| NPI Number | 1326685157 |
|---|---|
| Provider Enumeration Date | 11/27/2019 |
| Last Update Date | 11/24/2021 |
| Certification Date | 11/24/2021 |
| Medicare PECOS PAC ID | 7214388966 |
|---|---|
| Medicare Enrollment ID | O20240108003732 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326685157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Heidi Lynn Crispin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457801847 PECOS PAC ID: 8123479870 Enrollment ID: I20240108003964 |
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