| Kim E. Lucey Lcsw | |
|
1020 Sw Taylor St Ste 700 Portland OR 97205-2512 | |
| (971) 225-0105 | |
| Not Available |
| Full Name | Kim E. Lucey Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1020 Sw Taylor St Ste 700, Portland, Oregon |
| Authorized Official Name and Position | Kim E Lucey (PRESIDENT/OWNER) |
| Authorized Official Contact | 9712250105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim E. Lucey Lcsw 1020 Sw Taylor St Ste 700 Portland OR 97205-2512 Ph: (971) 225-0105 | Kim E. Lucey Lcsw 1020 Sw Taylor St Ste 700 Portland OR 97205-2512 Ph: (971) 225-0105 |
| NPI Number | 1386199461 |
|---|---|
| Provider Enumeration Date | 08/18/2016 |
| Last Update Date | 08/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386199461 | NPI | - | NPPES |
| 500653429 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L3676 (Oregon) | Primary |
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