Provider Demographics
NPI:1841338324
Name:LORAINE, KAY (MA, ATR-BC, CADCI)
Entity type:Individual
Prefix:MS
First Name:KAY
Middle Name:
Last Name:LORAINE
Suffix:
Gender:F
Credentials:MA, ATR-BC, CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 CHEMEKETA ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4151
Mailing Address - Country:US
Mailing Address - Phone:503-363-9154
Mailing Address - Fax:503-363-9154
Practice Address - Street 1:1340 CHEMEKETA ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4151
Practice Address - Country:US
Practice Address - Phone:503-363-9154
Practice Address - Fax:503-363-9154
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR04-03-24101YA0400X
ORATR-BC 01-083101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health