Rebel Heart Therapy Llc

LBN: Rebel Heart Therapy Llc
Rebel Heart Therapy Llc is an health care organization with primary practice located at 11 Ne Mlk Blvd Ste 203 , Portland OR 97232-3579. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Student, Health Care / Student in an Organized Health Care Education/Training Program. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Rebel Heart Therapy Llc can be contacted via phone (971) 350-1122, or through Fitz Gibbon, Morgan via phone (971) 350-1122.

Contact Information

Primary practice address
11 Ne Mlk Blvd Ste 203 Portland OR 97232-3579
Phone: (971) 350-1122
Fax: (971) 350-3401
Website:
Map and Directions
Authorized official contact:
Name: Fitz Gibbon, Morgan LMFT
Phone: (971) 350-1122

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1073146197
LBN Legal business name Rebel Heart Therapy Llc
DBA Doing business as
Authorized official Fitz Gibbon, Morgan LMFT
Entity Organization
Organization subpart 1 No
Enumeration date Feb 17th, 2020
Last updated Feb 10th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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