Provider Demographics
NPI:1841668977
Name:O'BRIEN, KATHERINE (LCSW-S)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 SE WOODSTOCK BLVD # 237
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-6267
Mailing Address - Country:US
Mailing Address - Phone:503-974-6412
Mailing Address - Fax:
Practice Address - Street 1:8627 SE LIEBE ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-3146
Practice Address - Country:US
Practice Address - Phone:503-318-1590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-06
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
ORL85311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical