Individual
DANIELLE BUTSCH TRIFONOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1511 DIVISION ST STE 101, OREGON CITY, OR 97045-1589
(503) 722-3705
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ICDC.151248-CS
OH
104100000X
Social Worker
5596
KY
1041C0700X
Clinical Social Worker
I.1200935.SUPV
OH
1041C0700X
Clinical Social Worker
Primary
L7781
OR
Other
Enumeration date
08/12/2009
Last updated
10/01/2024
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