Provider Demographics
NPI:1598513004
Name:HOLISTIC INTEGRATIVE COUNSELING
Entity type:Organization
Organization Name:HOLISTIC INTEGRATIVE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-433-3556
Mailing Address - Street 1:PO BOX 6014
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-0239
Mailing Address - Country:US
Mailing Address - Phone:503-433-3556
Mailing Address - Fax:
Practice Address - Street 1:821 SAGINAW ST S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4121
Practice Address - Country:US
Practice Address - Phone:503-433-3556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty