Individual
CINDY JO KAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I, AS, QMHA
Contact information
Practice address
15610 SE DIVISION ST, PORTLAND, OR 97236-2002
(971) 202-7897
(503) 760-7463
Mailing address
15610 SE DIVISION ST, PORTLAND, OR 97236-2002
(971) 202-7897
(503) 760-7463
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-05-17U
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/28/2008
Last updated
03/03/2015
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