NPIMap

Organization Active NPI

Birch Grove Counseling LLC

  • Clinical Social Worker
  • Keizer, OR
National Provider Identifier
1164727954
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4684 Issued in OR
Legal business name
BIRCH GROVE COUNSELING LLC
Practice address
4720 River Rd N
Keizer, OR 97303-4536
Phone
(907) 388-4689
Fax
(503) 318-2212
NPI assigned
Jan 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laurie Holland-Klein, LCSWNPI 1164591681
Title
Owner
Phone
(907) 388-4689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X L4684 OR Primary

Addresses

Primary practice location

4720 River Rd N
Keizer, OR 97303-4536

Mailing address

4720 River Rd N
Keizer, OR 97303-4536
Phone (907) 388-4689

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1164727954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034536",
            "telephone_number": "907-388-4689",
            "fax_number": "503-318-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 RIVER RD N",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973034536",
            "telephone_number": "907-388-4689",
            "fax_number": "503-318-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRCH GROVE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "HOLLAND-KLEIN",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-388-4689",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keizer, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.