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General NPI Number Information
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NPI Number | 1265765713
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Entity Type | Individual
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Provider Name | MICHAEL CRONIN LPC, CGACI, CADCI
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Gender | Male
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Dates
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Enumeration Date | 09/16/2009
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 3000 NE STUCKI AVE STE 230
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City | HILLSBORO
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State | OR
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Zip | 97124-7328
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Country | US
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Telephone | 503-980-1382
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Fax | 503-690-0678
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Provider Business Mailing Address
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Address Line | 7734 N DECATUR ST
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City | PORTLAND
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State | OR
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Zip | 97203-5510
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Country | US
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Telephone | 503-866-7022
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Fax | 503-690-0678
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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