NPI 1770310864 · live from the CMS NPI Registry
A Place For Hope And Healing
Social Worker, Clinical in Portland, OR. National Provider Identifier 1770310864, active.
NPI record
| NPI | 1770310864 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 1110 Se Alder St Ste 301, Portland, OR 97214 |
| Practice phone | 817-312-6370 |
| Mailing address | 17818 S Harding Rd, Oregon City, OR 97045 |
| Enumerated | September 13, 2024 |
| Last updated | September 13, 2024 |
| Authorized official | Justine Elstad, Owner |
| Other names | Introspective Collective |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Mental Health | 101YM0800X | — |
| Counselor, Professional | 101YP2500X | — |
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.