Provider Demographics
NPI:1134563521
Name:KINDY, TROY ALLEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:ALLEN
Last Name:KINDY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 SE 141ST AVE UNIT 12
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97236-2976
Mailing Address - Country:US
Mailing Address - Phone:503-616-6862
Mailing Address - Fax:
Practice Address - Street 1:33881 SE DAVONA DR
Practice Address - Street 2:
Practice Address - City:SCAPPOOSE
Practice Address - State:OR
Practice Address - Zip Code:97056-4540
Practice Address - Country:US
Practice Address - Phone:503-616-6862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL50701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical