Porchlight Custom Counseling LLC

NPI #1871069674 in Canby, Oregon

Provider Information

NPI Number: 1871069674
Entity Type: Organization
Organization Name: Porchlight Custom Counseling LLC
Primary Specialty: Counselor - Mental Health
Enumeration Date: Oct 18, 2018
Last Updated: Oct 18, 2018

Practice Location

Address: 455 S KNOTT ST
City: Canby
State: Oregon
ZIP Code: 97013-4426
Phone: (503) 395-3301

Authorized Official

Name: MICA RICHARDS, LMHC
Title: PART OWNER
Phone: (503) 395-3301

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Behavior Analyst	103K00000X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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