Provider Demographics
NPI:1306054473
Name:ROSEN, SARINA (LPC)
Entity type:Individual
Prefix:MS
First Name:SARINA
Middle Name:
Last Name:ROSEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7712 SW BARNES RD APT C
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6246
Mailing Address - Country:US
Mailing Address - Phone:503-297-6444
Mailing Address - Fax:
Practice Address - Street 1:230 NE 2ND AVE
Practice Address - Street 2:SUITE I
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3074
Practice Address - Country:US
Practice Address - Phone:503-297-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC-1236101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health