Provider Demographics
NPI:1740391770
Name:ANDREW P. PRICE LCSW, LLC
Entity Type:Organization
Organization Name:ANDREW P. PRICE LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:503-238-6007
Mailing Address - Street 1:2304 E BURNSIDE ST
Mailing Address - Street 2:STE. #202
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1677
Mailing Address - Country:US
Mailing Address - Phone:503-238-6007
Mailing Address - Fax:503-238-6007
Practice Address - Street 1:2304 E BURNSIDE ST
Practice Address - Street 2:STE. #202
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1677
Practice Address - Country:US
Practice Address - Phone:503-238-6007
Practice Address - Fax:503-238-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR33441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty