Provider Demographics
NPI:1174189856
Name:LAZAROU, ELENI (LCSW)
Entity Type:Individual
Prefix:
First Name:ELENI
Middle Name:
Last Name:LAZAROU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 NW LOVEJOY ST STE 302
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2344
Mailing Address - Country:US
Mailing Address - Phone:503-714-3390
Mailing Address - Fax:
Practice Address - Street 1:1720 NW LOVEJOY ST STE 302
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2344
Practice Address - Country:US
Practice Address - Phone:503-714-3390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-17
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL10344101YP2500X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional