St Mary's Home for Boys

NPI #1619057098 in Beaverton, Oregon

Provider Information

NPI Number: 1619057098
Entity Type: Organization
Organization Name: St Mary's Home for Boys
Primary Specialty: Psychologist - Counseling
Enumeration Date: Oct 17, 2006
Last Updated: May 7, 2013

Practice Location

Address: 16535 SW TUALATIN VALLEY HWY
City: Beaverton
State: Oregon
ZIP Code: 97006-5143
Phone: (503) 649-5651

Authorized Official

Name: MR. MICHAEL COLE
Title: ASSISTANT DIRECTOR
Phone: (503) 259-3201

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Psychologist - Cognitive & Behavioral — Cognitive & Behavioral	103TB0200X
Psychologist - Clinical — Clinical	103TC0700X
Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent	103TC2200X
Psychologist	103T00000X
Marriage & Family Therapist	106H00000X
Psychiatry & Neurology - Child & Adolescent Psychiatry — Child & Adolescent Psychiatry	2084P0804X
Clinic/Center - Adolescent and Children Mental Health — Adolescent and Children Mental Health	261QM0855X
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X
Psychiatric Hospital	283Q00000X
Psychologist - Counseling — Counseling	103TC1900X	Primary

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