Provider Demographics
NPI:1497435085
Name:BICKLEY, KIMBERLEE (LCSW)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:
Last Name:BICKLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIMBERLEE
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:8740 SW WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1744
Mailing Address - Country:US
Mailing Address - Phone:503-806-9382
Mailing Address - Fax:
Practice Address - Street 1:23839 SW DANIEL RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97078-5400
Practice Address - Country:US
Practice Address - Phone:503-806-9382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical