Provider Demographics
NPI:1235984352
Name:INTEGRATED SELF COUNSELING LLC
Entity type:Organization
Organization Name:INTEGRATED SELF COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARIMBEIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-461-6355
Mailing Address - Street 1:1020 SW TAYLOR ST STE 440
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2550
Mailing Address - Country:US
Mailing Address - Phone:503-461-6355
Mailing Address - Fax:503-386-3318
Practice Address - Street 1:1020 SW TAYLOR ST STE 440
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2550
Practice Address - Country:US
Practice Address - Phone:503-461-6355
Practice Address - Fax:503-386-3318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty