Provider Demographics
NPI:1487323911
Name:KEBEDE COUNSELING, LLC
Entity type:Organization
Organization Name:KEBEDE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KEBEDE-BERHANU
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:503-901-9248
Mailing Address - Street 1:9914 SE NANCY CT
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7259
Mailing Address - Country:US
Mailing Address - Phone:503-901-9248
Mailing Address - Fax:
Practice Address - Street 1:5416 N VANCOUVER AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-2734
Practice Address - Country:US
Practice Address - Phone:503-482-8270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty