Provider Demographics
NPI:1831398130
Name:ANDERSON, ROBERT BASKIN (LPC, CADC III)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BASKIN
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:LPC, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16869 LAKERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-6831
Mailing Address - Country:US
Mailing Address - Phone:503-997-3394
Mailing Address - Fax:
Practice Address - Street 1:4248 GALEWOOD ST STE 18
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-2405
Practice Address - Country:US
Practice Address - Phone:503-997-3394
Practice Address - Fax:888-690-0820
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
ORC1855101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)