| Counseling Corner Llc | |
|
7393 Se 118th Dr Portland OR 97266-4929 | |
| (971) 381-2769 | |
| Not Available |
| Full Name | Counseling Corner Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 7393 Se 118th Dr, Portland, Oregon |
| Authorized Official Name and Position | Jedidiah Smith (OWNER) |
| Authorized Official Contact | 9713812769 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Corner Llc 7393 Se 118th Dr Portland OR 97266-4929 Ph: () - | Counseling Corner Llc 7393 Se 118th Dr Portland OR 97266-4929 Ph: (971) 381-2769 |
| NPI Number | 1477293918 |
|---|---|
| Provider Enumeration Date | 03/31/2022 |
| Last Update Date | 07/28/2025 |
| Certification Date | 07/28/2025 |
| Medicare PECOS PAC ID | 1759809619 |
|---|---|
| Medicare Enrollment ID | O20250515000839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477293918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Jedidiah Smith |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1013471465 PECOS PAC ID: 2668990524 Enrollment ID: I20250515000881 |
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