Provider Demographics
NPI:1548328354
Name:ANNAND COUNSELING CENTR
Entity type:Organization
Organization Name:ANNAND COUNSELING CENTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRYE
Authorized Official - Middle Name:PENDARVIS
Authorized Official - Last Name:ANNAND
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:503-297-4363
Mailing Address - Street 1:10920 SW BARBUR BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-8600
Mailing Address - Country:US
Mailing Address - Phone:503-297-4363
Mailing Address - Fax:503-292-3415
Practice Address - Street 1:10920 SW BARBUR BLVD STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-8600
Practice Address - Country:US
Practice Address - Phone:503-297-4363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLETTER OF APPROVAL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty