Individual
CALVIN J MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II/LCSW
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(503) 228-9229
(503) 228-9558
Mailing address
5933 N HAIGHT AVE, PORTLAND, OR 97217-2180
(310) 595-0325
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
14-02-01
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
17-06-18
OR
104100000X
Social Worker
14564
CA
1041C0700X
Clinical Social Worker
Primary
L5541
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500677671
—
OR
05
—
500680652
—
OR
Enumeration date
06/05/2013
Last updated
08/07/2019
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