Provider Demographics
NPI:1851128615
Name:BREAKING THROUGH BARRIERS LLC
Entity type:Organization
Organization Name:BREAKING THROUGH BARRIERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:RAI
Authorized Official - Middle Name:
Authorized Official - Last Name:CARVALHO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-453-0869
Mailing Address - Street 1:2705 E. BURNSIDE ST. SUITE 206, PORTLAND OR, 97214
Mailing Address - Street 2:PMB 10
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214
Mailing Address - Country:US
Mailing Address - Phone:503-381-3437
Mailing Address - Fax:
Practice Address - Street 1:329 NE COUCH ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1332
Practice Address - Country:US
Practice Address - Phone:503-453-0869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty