Individual
STACY LAWHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, NCC
Contact information
Practice address
2279 NW IRVING ST, PORTLAND, OR 97210-3222
(541) 602-3536
Mailing address
PO BOX 10032, PORTLAND, OR 97296-0032
(541) 602-3536
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C3121
OR
Other
Enumeration date
05/29/2007
Last updated
08/14/2020
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