Provider Demographics
NPI:1588276364
Name:CLIMB BEHAVIORAL SOLUTIONS, LLC
Entity type:Organization
Organization Name:CLIMB BEHAVIORAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARIN-SHOVER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, LBA
Authorized Official - Phone:864-621-7408
Mailing Address - Street 1:2614 SE 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1311
Mailing Address - Country:US
Mailing Address - Phone:864-621-7408
Mailing Address - Fax:503-802-5351
Practice Address - Street 1:809B SE SHERMAN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-4666
Practice Address - Country:US
Practice Address - Phone:864-621-7408
Practice Address - Fax:503-802-5351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1790118552OtherNPI TYPE 1
OR500685400Medicaid