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General NPI Number Information
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NPI Number | 1083141444
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Entity Type | Individual
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Provider Name | LAURIE KERRIDGE M.A., LPC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/16/2017
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 7175 SW BEVELAND RD STE 205
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City | PORTLAND
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State | OR
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Zip | 97223-8665
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Country | US
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Telephone | 858-449-1589
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Fax | 720-419-0228
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Provider Business Mailing Address
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Address Line | 205 KEN PRATT BLVD STE 120-40
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City | LONGMONT
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State | CO
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Zip | 80501-8993
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Country | US
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Telephone | 858-449-1589
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Fax | 720-419-0228
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH61314459
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0017006
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C5724
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License Number State | OR
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