Psychological Services Connection Llc

NPI Registration Record

Provider / Organization	NPI	Date Certified
PSYCHOLOGICAL SERVICES CONNECTION LLC	1275260465	2022-08-07

The organization Psychological Services Connection Llc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1275260465. Registration indicates Psychological Services Connection Llc is a provider of services with a specialization in Ambulatory Health Care Facilities, Clinic/Center (Clinic/Center: Mental Health (Including Community Mental Health Center),, ) (Community Mental Health Center, ) (Clinic/Center Mental Health (Including Community Mental Health Center),, Ambulatory Health Care Facilities) (Clinic/Center, )

Other Names:

PSC
Psychological Services Corporation

Entity Type	Organization

Provider Organization	PSYCHOLOGICAL SERVICES CONNECTION LLC
Other Provider Organization	PSYCHOLOGICAL SERVICES CORPORATION
Practice Office Address	811 SW 6TH AVE STE 1000 PORTLAND, OR US
Practice Office Telephone	5033343035
Practice Office Fax	5039619212
Mailing Address	811 SW 6TH AVE STE 1000 PORTLAND, OR 972041345 US
Business Telephone	5033343035
Business Fax	5039619212
Authorized Official	JULIE KEANAAINA, OWNER 5039277724

Offices / Locations

Address	City / State	Phone / Fax
5020 NE Martin Luther King	Portland, OR 972113204	5039277724
222 NW Davis St Ste 309	Portland, OR 972093900	5039277724

HPT Codes

Code	Practice	License No State
261QM0801X PRIMARY	Ambulatory Health Care Facilities Clinic/Center Clinic/Center: Mental Health (Including Community Mental Health Center), Community Mental Health Center Clinic/Center Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities Clinic/Center

OPI Codes

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