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Rebel Heart Therapy Llc
Student in an Organized Health Care Education/Training Program in Portland, Oregon
NPI 1073146197

Rebel Heart Therapy Llc is a Student in an Organized Health Care Education/Training Program based in Portland, OR. Rebel Heart Therapy Llc practices in Portland, OR. The NPI Number for Rebel Heart Therapy Llc is 1073146197 and holds a License No. (Oregon).

The current practice location address for Rebel Heart Therapy Llc is 11 Ne Mlk Blvd Ste 203, Portland, OR and can be reached out via phone at 971-350-1122 and via fax at 971-350-3401.

Location: 11 Ne Mlk Blvd Ste 203, Portland, OR, 97232-3579
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1073146197
Provider Name
Rebel Heart Therapy Llc
Credential
Provider Entity Type
Organization
Address
11 Ne Mlk Blvd Ste 203, Portland, OR, 97232-3579
Phone Number
971-350-1122
Fax Number
971-350-3401
Provider Enumeration Date
02/17/2020
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
11 Ne Mlk Blvd Ste 203
City
Portland
State
Oregon
Zip
97232-3579
Phone Number
971-350-1122
Fax Number
971-350-3401
person
Provider Business Mailing Address Details
Address
11 Ne Mlk Blvd Ste 203
City
Portland
State
Oregon
Zip
97232-3579
Phone Number
971-350-1122
Fax Number
971-350-3401
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Marriage & Family Therapist
Speciality
-
Taxonomy
106H00000X
License No.
()
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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