| Lighthouse Counseling | |
|
5201 Sw Westgate Dr Ste 100 Portland OR 97221-2424 | |
| (469) 297-0096 | |
| Not Available |
| Full Name | Lighthouse Counseling |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 5201 Sw Westgate Dr Ste 100, Portland, Oregon |
| Authorized Official Name and Position | Earnest Wallace (CEO) |
| Authorized Official Contact | 4692970096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Counseling 5201 Sw Westgate Dr Ste 100 Portland OR 97221-2424 Ph: (469) 297-0096 | Lighthouse Counseling 5201 Sw Westgate Dr Ste 100 Portland OR 97221-2424 Ph: (469) 297-0096 |
| NPI Number | 1366136541 |
|---|---|
| Provider Enumeration Date | 06/08/2023 |
| Last Update Date | 09/29/2023 |
| Certification Date | 09/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366136541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
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