NPIMap

Organization Active NPI

Coordinated Counseling for Children

Doing business as Victoria Wisdom-Imbach

  • Professional Counselor
  • Salem, OR
National Provider Identifier
1295251437
Registry record updated Aug 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C3841 Issued in OR
Legal business name
COORDINATED COUNSELING FOR CHILDREN
Doing business as
Victoria Wisdom-Imbach
Practice address
528 Cottage St NE
Salem, OR 97301-3811
Phone
(303) 946-9071
Fax
(267) 288-0775
NPI assigned
Aug 18, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2017

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

Authorized official

Name
Dr. Victoria Wisdom-Imbach, PHDNPI 1033441399
Title
Owner
Phone
(303) 946-9071

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X C3841 OR Primary

Addresses

Primary practice location

528 Cottage St NE
Salem, OR 97301-3811

Mailing address

295 Church St SE Apt 305
Salem, OR 97301-3832
Phone (303) 946-9071

Other names 1

  • Victoria Wisdom-Imbach Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coordinated Counseling for Children2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

528 Cottage St NE
Salem, OR 97301
Phone (503) 450-9900

Practitioners & affiliated clinicians

Practitioners 5

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": "1503014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503014400000",
    "number": "1295251437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 CHURCH ST SE APT 305",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013832",
            "telephone_number": "303-946-9071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 COTTAGE ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013811",
            "telephone_number": "303-946-9071",
            "fax_number": "267-288-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COORDINATED COUNSELING FOR CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-18",
        "last_updated": "2017-08-18",
        "status": "A",
        "authorized_official_last_name": "WISDOM-IMBACH",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-946-9071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victoria Wisdom-Imbach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2017; 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.