NPI 1124851167 · live from the CMS NPI Registry
A Little Light Collective, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Portland, OR. National Provider Identifier 1124851167, active.
NPI record
| NPI | 1124851167 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Mental Health (Including Community Mental Health Center) 261QM0801X |
| Practice location | 4605 Ne Fremont St Ste 210f, Portland, OR 97213 |
| Practice phone | 503-994-6702 |
| Mailing address | 1717 Ne 42nd Ave Ste 3200, Portland, OR 97213 |
| Enumerated | August 23, 2024 |
| Last updated | June 3, 2025 |
| Authorized official | Jordan Dobrovolny, Member |
| Other names | Jordan Dobrovolny LCSW |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical | 1041C0700X | — |
| Clinic/Center, Mental Health (Including Community Mental Health Center) primary | 261QM0801X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.