Provider Demographics
NPI:1376730986
Name:PARTAK, DEAH RENEE (LCSW, CADCII)
Entity Type:Individual
Prefix:MS
First Name:DEAH
Middle Name:RENEE
Last Name:PARTAK
Suffix:
Gender:F
Credentials:LCSW, CADCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16409 SE DIVISION ST STE 216
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-1982
Mailing Address - Country:US
Mailing Address - Phone:503-701-2294
Mailing Address - Fax:
Practice Address - Street 1:3407 S CORBETT AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4621
Practice Address - Country:US
Practice Address - Phone:503-701-2294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11-06-94101YA0400X
OR45761041C0700X
ORL45761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)