Phil Bergland, LPC
Counselor, Mental Health in Portland, OR. Individual provider (NPI-1).
NPI number1174908321
StatusActive
Last updated in NPPESSep 2, 2016
Details
- NPI
- 1174908321
- Entity type
- Individual (NPI-1)
- Name
- Phil Bergland
- Credential
- LPC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 29, 2015
- Last updated
- Sep 2, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | C3611 | OR | Yes |
| 101YP2500X | Counselor, Professional | LH60618681 | WA |
Practice location
11220 Se Stark StSuite 6
Portland, OR 97216
Phone 503-908-4681
Mailing address
15114 Ne 5th StVancouver, WA 98684-8108
Phone 360-980-2326
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