NPIMap

Organization Active NPI

Wolf Pack Consulting and Therapeutic Services LLC

  • Mental Health Counselor
  • Beaverton, OR
National Provider Identifier
1336677988
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
L4228 Issued in OR
Legal business name
WOLF PACK CONSULTING AND THERAPEUTIC SERVICES LLC
Practice address
16365 NW Twin Oaks Dr.
Beaverton, OR 97006-4741
Phone
(415) 908-5287
NPI assigned
May 26, 2017
Last updated
Sep 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Karissa TongueNPI 1295011096
Title
Operations Manager
Phone
(541) 908-5287

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
Mental Health Counselor 101YM0800X L4228 OR Primary

Addresses

Primary practice location

16365 NW Twin Oaks Dr.
Beaverton, OR 97006-4741

Mailing address

16055 SW Walker Rd # 443
Beaverton, OR 97006-4942
Phone (971) 344-3844

National Provider Directory

National Provider Directory

Locations

14355 SW Allen Blvd
Ste 150
Beaverton, OR 97005
Phone (503) 806-5700

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1336677988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 SW WALKER RD # 443",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064942",
            "telephone_number": "971-344-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16365 NW TWIN OAKS DR.",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970064741",
            "telephone_number": "415-908-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF PACK CONSULTING AND THERAPEUTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-26",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-02",
        "status": "A",
        "authorized_official_last_name": "TONGUE",
        "authorized_official_first_name": "KARISSA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "541-908-5287"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "L4228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.