Interpersonal Growth Organization, Llc | |
2279 Nw Irving St Portland OR 97210-3222 | |
(541) 602-3536 | |
Not Available |
Full Name | Interpersonal Growth Organization, Llc |
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Speciality | Counselor - Mental Health |
Location | 2279 Nw Irving St, Portland, Oregon |
Authorized Official Name and Position | Stacy Lawhead (OWNER) |
Authorized Official Contact | 5416023536 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Interpersonal Growth Organization, Llc Po Box 10032 Portland OR 97296-0032 Ph: (541) 602-3536 | Interpersonal Growth Organization, Llc 2279 Nw Irving St Portland OR 97210-3222 Ph: (541) 602-3536 |
NPI Number | 1740788926 |
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Provider Enumeration Date | 01/23/2018 |
Last Update Date | 08/14/2020 |
Certification Date | 08/14/2020 |
Identifier | Type | State | Issuer |
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1740788926 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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