Modupe Desiree Bansile is a Portland, Oregon based counselor who is specialized as Counselor. Active license number of Modupe Desiree Bansile is THW2156 for Peer Specialist in Oregon. Her current practice location is 209 Sw Fourth Ave, Suite 520, Portland. Patients can book an appointment with her at 541-556-9195.
Modupe Desiree Bansile is a trained and licensed mental health professional who helps individuals, couples, or groups manage and overcome emotional, psychological, behavioral, or relationship challenges. She works with people dealing with anxiety, depression, mood disorders, trauma, post-traumatic stress disorder (PTSD), grief and loss etc. She support her clients by understanding their thoughts, emotions, and behaviors.
Complete Profile:
Modupe Desiree Bansile speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Name:
Modupe Desiree Bansile
Specialization:
Counselor
Gender:
Female
Accepts Medicare Assignment:
No
Practice Address:
209 Sw Fourth Ave, Suite 520, Portland, Oregon, 97204
Phone:
541-556-9195
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1790133031
NPI Enumeration Date:
26 May, 2016
NPI Last Update On:
30 Oct, 2018
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Modupe Desiree Bansile are as mentioned below.
License Number
Specialization
State
Status
THW2156
Peer Specialist
Oregon
Primary
Counselor
Secondary
Other Medical Identifiers:
Other legacy medical identifiers associated with Modupe Desiree Bansile such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
THW2156
Medicaid
Oregon
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
11073 Se Main St, Milwaukie, Oregon
Zip:
97222
Phone Number:
541-556-9195
Patients can reach Modupe Desiree Bansile at 209 Sw Fourth Ave, Suite 520, Portland, Oregon or can call to book an appointment on 541-556-9195. *Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 14 July, 2025.