Provider Demographics
NPI:1134280431
Name:KLEIN, ALLYSON LESLIE (LCSW)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:LESLIE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4146 LAKEVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-5551
Mailing Address - Country:US
Mailing Address - Phone:503-832-4509
Mailing Address - Fax:
Practice Address - Street 1:4146 LAKEVIEW BLVD
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-5551
Practice Address - Country:US
Practice Address - Phone:503-832-4509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2024-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS208151041C0700X
ORL102031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical