Provider Demographics
NPI:1831409580
Name:AMOROSE, KATHLEEN LINDA (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:LINDA
Last Name:AMOROSE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 5TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97034-3052
Mailing Address - Country:US
Mailing Address - Phone:503-697-1001
Mailing Address - Fax:
Practice Address - Street 1:440 5TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3052
Practice Address - Country:US
Practice Address - Phone:503-697-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR39201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical