Provider Demographics
NPI:1073184784
Name:CONROY, KERRINS THOMAS III (NCC, LPC INTERN)
Entity Type:Individual
Prefix:MR
First Name:KERRINS
Middle Name:THOMAS
Last Name:CONROY
Suffix:III
Gender:M
Credentials:NCC, LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7346 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-5775
Mailing Address - Country:US
Mailing Address - Phone:503-746-3373
Mailing Address - Fax:
Practice Address - Street 1:7346 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-5775
Practice Address - Country:US
Practice Address - Phone:503-746-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-03
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor