Provider Demographics
NPI:1457645962
Name:OLBRICH-TENNEY, CATHY (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:OLBRICH-TENNEY
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 1:3710 SW US VETERANS HOSPITAL ROAD
Mailing Address - Street 2:VAMC/P35C
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97207
Mailing Address - Country:US
Mailing Address - Phone:503-220-8262
Mailing Address - Fax:503-273-5243
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL ROAD
Practice Address - Street 2:VAMC/P35C
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97207
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:503-273-5243
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR37341041C0700X
CA166441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical