Provider Demographics
NPI:1417153586
Name:LUCRECIA V SUAREZ G LCSW PC
Entity Type:Organization
Organization Name:LUCRECIA V SUAREZ G LCSW PC
Other - Org Name:CONEXIONES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUCRECIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:503-235-8057
Mailing Address - Street 1:2325 E BURNSIDE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1655
Mailing Address - Country:US
Mailing Address - Phone:503-235-8057
Mailing Address - Fax:503-235-5455
Practice Address - Street 1:2325 E BURNSIDE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1655
Practice Address - Country:US
Practice Address - Phone:503-235-8057
Practice Address - Fax:503-235-5455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health