Provider Demographics
NPI:1013210970
Name:STROUP, TERESA L (BA, MSW, LCSW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:L
Last Name:STROUP
Suffix:
Gender:F
Credentials:BA, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 SW OAK ST STE 500520
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6583
Mailing Address - Country:US
Mailing Address - Phone:971-364-8069
Mailing Address - Fax:971-209-7261
Practice Address - Street 1:9600 SW OAK ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6583
Practice Address - Country:US
Practice Address - Phone:971-364-8069
Practice Address - Fax:971-209-7261
Is Sole Proprietor?:No
Enumeration Date:2010-12-15
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL69251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR090450Medicaid