Healthcare Provider Details

I. General information

NPI: 1235005638
Provider Name (Legal Business Name): STEVEN BALSHEM, LCSW - LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E BURNSIDE ST STE 100
PORTLAND OR
97214-1850
US

IV. Provider business mailing address

2705 E BURNSIDE ST STE 206
PORTLAND OR
97214-1768
US

V. Phone/Fax

Practice location:
  • Phone: 503-662-2536
  • Fax:
Mailing address:
  • Phone: 503-662-2536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: STEVEN W BALSHEM
Title or Position: MENTAL HEALTH THERAPIST
Credential: LCSW
Phone: 503-662-2536