Provider Demographics
NPI:1992682314
Name:ACKERMAN PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:ACKERMAN PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:LEANORA
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:971-352-1601
Mailing Address - Street 1:2000 NE 42ND AVE STE D2021
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-1399
Mailing Address - Country:US
Mailing Address - Phone:971-352-1601
Mailing Address - Fax:503-543-6040
Practice Address - Street 1:51579 COLUMBIA RIVER HWY STE I
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-8411
Practice Address - Country:US
Practice Address - Phone:971-352-1601
Practice Address - Fax:503-543-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty