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General NPI Number Information
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NPI Number | 1740391770
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Entity Type | Organization
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Legal Business Name | ANDREW P. PRICE LCSW, LLC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2304 E BURNSIDE ST STE. #202
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City | PORTLAND
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State | OR
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Zip | 97214-1677
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Country | US
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Telephone | 503-238-6007
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Fax | 503-238-6007
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Provider Business Mailing Address
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Address Line | 2304 E BURNSIDE ST STE. #202
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City | PORTLAND
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State | OR
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Zip | 97214-1677
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Country | US
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Telephone | 503-238-6007
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Fax | 503-238-6007
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ANDREW PRICE
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Credential | MSW, LCSW
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Telephone | 503-238-6007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3344
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License Number State | OR
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