Individual provider · Type 1 NPI

Carly Rae Gustafson, BA

Counselor · Portland, OR

NPI number 1780111062 Active

Practice location

1904 SE Division St
Portland, OR 97202-1146

Call (503) 517-8663 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1780111062

Carly Rae Gustafson, BA's National Provider Identifier is 1780111062, issued on May 17, 2017. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Portland, OR. The record was last updated on Jul 21, 2022.