Individual
ATHENA PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3583 NE BROADWAY ST, PORTLAND, OR 97232-1820
(503) 819-4181
(503) 827-0299
Mailing address
3583 NE BROADWAY ST, PORTLAND, OR 97232-1820
(503) 819-4181
(503) 827-0299
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
L4462
OR
1041C0700X
Clinical Social Worker
Primary
L4462
OR
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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