Provider Demographics
NPI:1235312968
Name:HENSON, KATIE MORRIS (LPC, CADCII)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:MORRIS
Last Name:HENSON
Suffix:
Gender:F
Credentials:LPC, CADCII
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:MORRIS HENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, CADCII, LADC
Mailing Address - Street 1:1516 SE GLENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-5659
Mailing Address - Country:US
Mailing Address - Phone:405-361-1153
Mailing Address - Fax:
Practice Address - Street 1:1110 SE ALDER ST STE 301
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2400
Practice Address - Country:US
Practice Address - Phone:503-731-7103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18-R-42101YA0400X
OK2713101YP2500X
ORC5224101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)