1417281338 NPI number — LESLIE SUSAN ORR

Table of content: (NPI 1417281338)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417281338 NPI number — LESLIE SUSAN ORR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LESLIE SUSAN ORR
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMPASSIONATE HOPE COUNSELING
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417281338
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4430 ROSE VALLEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KELSO
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98626-9426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-578-0634
Provider Business Mailing Address Fax Number:
360-414-4349

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 1ST AVE
Provider Second Line Business Practice Location Address:
3B
Provider Business Practice Location Address City Name:
LONGVIEW
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98632-3270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-425-3854
Provider Business Practice Location Address Fax Number:
360-423-4107
Provider Enumeration Date:
09/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ORR
Authorized Official First Name:
LESLIE
Authorized Official Middle Name:
S
Authorized Official Title or Position:
LICENSED MENTAL HEALTH COUNSELOR
Authorized Official Telephone Number:
360-578-0634

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  601497696 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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