Modupe Desiree Bansile - Portland, OR

Modupe Desiree Bansile

Peer Specialist in Portland, Oregon

NPI 1790133031

Modupe Desiree Bansile is a Peer Specialist based in Milwaukie, OR. Modupe Desiree Bansile practices in Portland, OR. The NPI Number for Modupe Desiree Bansile is 1790133031 and holds a License No. (Oregon).

The current practice location address for Modupe Desiree Bansile is 209 Sw Fourth Ave, Suite 520, Portland, OR and can be reached out via phone at 541-556-9195.

Location: 209 Sw Fourth Ave, Suite 520, Portland, OR, 97222

NPI Number

1790133031

Provider Name

Modupe Desiree Bansile

Credential

Provider Entity Type

Individual

Gender

Female

Address

209 Sw Fourth Ave, Suite 520, Portland, OR, 97222

Phone Number

541-556-9195

Fax Number

Provider Enumeration Date

05/26/2016

Last Update Date

03/09/2024

Identifier	Type	State	Issuer
THW2156	05	OR

Address

209 Sw Fourth Ave, Suite 520

City

Portland

State

Oregon

Zip

97204

Phone Number

541-556-9195

Fax Number

Address

209 Sw Fourth Ave, Suite 520

City

Portland

State

Oregon

Zip

97204

Phone Number

541-556-9195

Fax Number

Type

Behavioral Health & Social Service Providers

Classification

Counselor

Speciality

Taxonomy

101Y00000X

License No.

THW2156 (Oregon)

Definition

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.

Type

Other Service Providers

Classification

Peer Specialist

Speciality

Taxonomy

175T00000X

License No.

()

Definition

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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