Provider Demographics
NPI:1245399765
Name:LOPAS, JENNIFER ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:LOPAS
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 1:532 NE 56TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-3152
Mailing Address - Country:US
Mailing Address - Phone:503-250-1188
Mailing Address - Fax:503-536-6450
Practice Address - Street 1:532 NE 56TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3152
Practice Address - Country:US
Practice Address - Phone:503-250-1188
Practice Address - Fax:503-536-6450
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical