Provider Demographics
NPI:1811130008
Name:KLIEWER, LEXY MADELINE (LCSW)
Entity type:Individual
Prefix:
First Name:LEXY
Middle Name:MADELINE
Last Name:KLIEWER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LEXY
Other - Middle Name:MADELINE
Other - Last Name:VANORIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1151 N ADAIR ST
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:OR
Mailing Address - Zip Code:97113-8900
Mailing Address - Country:US
Mailing Address - Phone:503-359-5564
Mailing Address - Fax:503-359-8532
Practice Address - Street 1:1151 N ADAIR ST
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:OR
Practice Address - Zip Code:97113-8900
Practice Address - Country:US
Practice Address - Phone:503-359-5564
Practice Address - Fax:503-359-8532
Is Sole Proprietor?:No
Enumeration Date:2009-04-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL46961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500646356Medicaid