Provider Demographics
NPI:1720395809
Name:PORTERFIELD, HOPE MARIE (CADC III, LCSW, QMHP)
Entity Type:Individual
Prefix:MS
First Name:HOPE
Middle Name:MARIE
Last Name:PORTERFIELD
Suffix:
Gender:F
Credentials:CADC III, LCSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 NW HARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754-1445
Mailing Address - Country:US
Mailing Address - Phone:541-209-0017
Mailing Address - Fax:
Practice Address - Street 1:245 NW HARWOOD ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1445
Practice Address - Country:US
Practice Address - Phone:541-209-0017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10-03-20101YA0400X
101YM0800X
ORL106511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500700804Medicaid
OR283234Medicaid