1598196404 NPI number — DR. ELIZABETH WOSLEY-GEORGE PH.D., LPC(OREGON)

Table of content: DR. ELIZABETH WOSLEY-GEORGE PH.D., LPC(OREGON) (NPI 1598196404)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598196404 NPI number — DR. ELIZABETH WOSLEY-GEORGE PH.D., LPC(OREGON)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOSLEY-GEORGE
Provider First Name:
ELIZABETH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D., LPC(OREGON)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1598196404
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5511 SE HAWTHORNE BLVD
Provider Second Line Business Mailing Address:
A NEW DAY COUNSELING CENTER
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97215-3367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-517-1895
Provider Business Mailing Address Fax Number:
503-517-1927

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5511 SE HAWTHORNE BLVD
Provider Second Line Business Practice Location Address:
A NEW DAY COUNSELING CENTER
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97215-3367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-517-1895
Provider Business Practice Location Address Fax Number:
503-517-1927
Provider Enumeration Date:
12/02/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  E.0001711-SUPV , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: C2542 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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