# MARY CALDERON, LCSW, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790941862
- **Authorized official:** MS. MARY CALDERON LCSW (LICENSED CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (503) 675-2830

## Contact information

- **Practice address:** 3990 COLLINS WAY, SUITE \#202, LAKE OSWEGO, OR 97035-3480
- **Practice address phone:** (503) 675-2830
- **Practice address fax:** (503) 675-2852
- **Mailing address:** 3990 COLLINS WAY, SUITE \#202, LAKE OSWEGO, OR 97035-3480
- **Mailing address phone:** (503) 675-2830
- **Mailing address fax:** (503) 675-2852

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 07/29/2008
- **Last updated:** 08/26/2009