Provider Demographics
NPI:1962837294
Name:BEERGER, DOROTHY CAROLINE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:CAROLINE
Last Name:BEERGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:JAQUELYB
Other - Middle Name:
Other - Last Name:GODWIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:P.O. BOX 1332
Mailing Address - Street 2:
Mailing Address - City:CANNON BEACH
Mailing Address - State:OR
Mailing Address - Zip Code:97110
Mailing Address - Country:US
Mailing Address - Phone:503-436-1041
Mailing Address - Fax:
Practice Address - Street 1:4508 LOGAN LANE
Practice Address - Street 2:
Practice Address - City:TOLOVANA PARK
Practice Address - State:OR
Practice Address - Zip Code:97145-4508
Practice Address - Country:US
Practice Address - Phone:503-436-1041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR94-R-05101YA0400X
ORC3132101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)