Provider Demographics
NPI:1982048641
Name:MCGRATH, RENA C (LPC)
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:C
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:RENA
Other - Middle Name:
Other - Last Name:LUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:TURNER
Mailing Address - State:OR
Mailing Address - Zip Code:97392-0072
Mailing Address - Country:US
Mailing Address - Phone:503-910-5033
Mailing Address - Fax:
Practice Address - Street 1:7770 3RD ST SE STE 103
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:OR
Practice Address - Zip Code:97392-9454
Practice Address - Country:US
Practice Address - Phone:503-910-5033
Practice Address - Fax:503-743-1033
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4755101YP2500X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional