Provider Demographics
NPI:1619025145
Name:LEFOR, KATHY LOUISE (LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:LOUISE
Last Name:LEFOR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16340 SW SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-4889
Mailing Address - Country:US
Mailing Address - Phone:503-642-4442
Mailing Address - Fax:
Practice Address - Street 1:9900 SW WILSHIRE ST
Practice Address - Street 2:#230
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5035
Practice Address - Country:US
Practice Address - Phone:971-322-8672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCI788101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional