# LL GONCE INC

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

## Provider details

- **NPI number:** 1831520493
- **Authorized official:** LAURA LEE GONCE LCSW (PRESIDENT)
- **Authorized official phone:** (503) 704-3064

## Contact information

- **Practice address:** 1318 NW 20TH AVE \# A-1, PORTLAND, OR 97209-1671
- **Practice address phone:** (503) 704-3064
- **Practice address fax:** (503) 961-7703
- **Mailing address:** 1736 N WILLAMETTE BLVD, PORTLAND, OR 97217-4415

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | L2426 | OR | Yes |

## Other

- **Enumeration date:** 12/09/2013
- **Last updated:** 12/09/2013