Provider Demographics
NPI:1003360611
Name:HERSHMAN, ALAN (LCSW)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:HERSHMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 THATCHER RD
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-7554
Mailing Address - Country:US
Mailing Address - Phone:503-830-2607
Mailing Address - Fax:
Practice Address - Street 1:14255 SW BRIGADOON CT STE 80
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3368
Practice Address - Country:US
Practice Address - Phone:503-641-1475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL41191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical