Provider Demographics
NPI:1104526284
Name:ELCANO COUNSELING LLC
Entity type:Organization
Organization Name:ELCANO COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ROBERT LIU
Authorized Official - Last Name:ELCANO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-250-0130
Mailing Address - Street 1:1461 SW A AVE
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4218
Mailing Address - Country:US
Mailing Address - Phone:541-250-0130
Mailing Address - Fax:
Practice Address - Street 1:1461 SW A AVE
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4218
Practice Address - Country:US
Practice Address - Phone:541-250-0130
Practice Address - Fax:877-338-1628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty