Individual provider · Type 1 NPI

Heidi Petra Davisson, MA

Mental Health Counselor · Portland, OR

NPI number 1891192316 Active

Practice location

3939 NE Hancock St Ste 117
Portland, OR 97212-5321

Call (503) 929-7750 Map

Mailing address

63 NE Thompson St
Portland, OR 97212-3741

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XC4019 (OR)
Professional Counselor 101YP2500XC4019 (OR)
Counselor 101Y00000XC4019 (OR)
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1891192316

Heidi Petra Davisson, MA's National Provider Identifier is 1891192316, issued on Nov 26, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Nov 29, 2023.