Individual
LAURIE MCDERMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CADC III
Contact information
Practice address
412 SW 12TH AVE, PORTLAND, OR 97205-2329
(503) 228-7134
Mailing address
232 NW 6TH AVE, PORTLAND, OR 97209-3609
(503) 294-1681
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
09-06-67
OR
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L4614
OR
Other
Enumeration date
07/29/2010
Last updated
07/29/2010
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