Provider Demographics
NPI:1891206199
Name:BEHRER, JONA (MS, LPC)
Entity type:Individual
Prefix:
First Name:JONA
Middle Name:
Last Name:BEHRER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 NE HOYT ST APT 524
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-3659
Mailing Address - Country:US
Mailing Address - Phone:971-361-8788
Mailing Address - Fax:
Practice Address - Street 1:2931 NE BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1760
Practice Address - Country:US
Practice Address - Phone:971-361-8788
Practice Address - Fax:971-275-1749
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4670101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty