Individual
STEVEN GARY HERZBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW,QMHP,MSW
Contact information
Practice address
2415 SE 43RD AVE, SUITE 100, PORTLAND, OR 97206-1600
(503) 963-2575
(503) 872-0116
Mailing address
PO BOX 396, CARSON, WA 98610-0396
(509) 427-5973
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L3476
OR
1041C0700X
Clinical Social Worker
LCS 13627
CA
1041C0700X
Clinical Social Worker
LW00007768
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A021555-6
HMSA BC/BS
—
Enumeration date
09/15/2006
Last updated
09/24/2009
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