Heather Fogg
Individual provider Active NPI Mental Health Counselor · Beaverton, OR
NPI 1255700134 · NPPES record last updated Sep 21, 2015
Key facts
- NPI
- 1255700134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 1500 NW Bethany Blvd
Suite 320
Beaverton, OR 97006-5208 - Phone
- (503) 567-3260
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
1500 NW Bethany Blvd
Suite 320
Beaverton, OR 97006-5208
Mailing address
PO Box 82819
Portland, OR 97282-0819
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 164936 | Medicaid | OR |
Other providers in Beaverton, OR
- Andrea Lynne Floyd
- Danial Floyd
- Judy Ellen Flynn
- Katherine Elizabeth Fobert
- Alex Taylor Foerman
- Marni Louise Foley
- Carrie D Foote
- Patrice M Foote
- For the People LLC
- Anna Beatrice Forcelle
All providers in Beaverton, OR · Mental Health Counselor in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.