Provider Demographics
NPI:1821375676
Name:DONEEN, CELESTE IAN (LCSW, MAC, CADC III)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:IAN
Last Name:DONEEN
Suffix:
Gender:F
Credentials:LCSW, MAC, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 SE MILLER ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6705
Mailing Address - Country:US
Mailing Address - Phone:503-317-1385
Mailing Address - Fax:
Practice Address - Street 1:6124 SE MILWAUKIE AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-5347
Practice Address - Country:US
Practice Address - Phone:503-317-1385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR08-12-78101YA0400X
ORA25231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)