Provider Demographics
NPI:1407340318
Name:HOMESPUN COUNSELING, LLC
Entity type:Organization
Organization Name:HOMESPUN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:541-232-1930
Mailing Address - Street 1:33055 SE PEORIA RD
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-2529
Mailing Address - Country:US
Mailing Address - Phone:541-232-1930
Mailing Address - Fax:
Practice Address - Street 1:33055 SE PEORIA RD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-2529
Practice Address - Country:US
Practice Address - Phone:541-232-1930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTRY COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR989103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty