Provider Demographics
NPI:1235782293
Name:SAREN, MARK A (LPC, MA, MBA)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:A
Last Name:SAREN
Suffix:
Gender:M
Credentials:LPC, MA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 VISTA LAKE ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97462-8705
Mailing Address - Country:US
Mailing Address - Phone:866-972-0235
Mailing Address - Fax:
Practice Address - Street 1:179 VISTA LAKE ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:OR
Practice Address - Zip Code:97462-8705
Practice Address - Country:US
Practice Address - Phone:503-560-7723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-18
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR6009101YM0800X
OR101YP2500X
ORC6589101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500770525Medicaid