Provider Demographics
NPI:1407696727
Name:ARUN WELLNESS AND PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:ARUN WELLNESS AND PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:ALISA
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:971-402-9705
Mailing Address - Street 1:4039 N MISSISSIPPI AVE STE 307
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1477
Mailing Address - Country:US
Mailing Address - Phone:971-402-9705
Mailing Address - Fax:
Practice Address - Street 1:4039 N MISSISSIPPI AVE STE 307
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1477
Practice Address - Country:US
Practice Address - Phone:971-402-9705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health