Provider Demographics
NPI:1861743254
Name:CHAKLADER, ARTIN (LPC)
Entity type:Individual
Prefix:
First Name:ARTIN
Middle Name:
Last Name:CHAKLADER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3222 SE MILWAUKIE AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-2451
Mailing Address - Country:US
Mailing Address - Phone:570-592-8167
Mailing Address - Fax:
Practice Address - Street 1:811 E BURNSIDE ST STE 217
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214
Practice Address - Country:US
Practice Address - Phone:503-707-6782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health