Provider Demographics
NPI:1851526024
Name:CUPP, CATHERINE ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANNE
Last Name:CUPP
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 1:13570 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3869
Mailing Address - Country:US
Mailing Address - Phone:541-377-9011
Mailing Address - Fax:503-526-3912
Practice Address - Street 1:4900 SW GRIFFITH DR STE 235
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-4649
Practice Address - Country:US
Practice Address - Phone:541-377-9011
Practice Address - Fax:503-526-3812
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-18
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1182101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC1182OtherLICENCED PROFESSIONAL COUNSELOR