Provider Demographics
NPI:1548030521
Name:TOG COUNSELING LLC
Entity type:Organization
Organization Name:TOG COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:OLEARY GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:971-716-1710
Mailing Address - Street 1:3495 NE JACOB ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-8902
Mailing Address - Country:US
Mailing Address - Phone:971-716-1710
Mailing Address - Fax:971-423-0654
Practice Address - Street 1:640 NE 3RD ST STE 200
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4630
Practice Address - Country:US
Practice Address - Phone:971-716-1710
Practice Address - Fax:971-423-0654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1205238995Medicaid