MEDICARE: ANDREW R PROCHNIAK LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	C2969	OR

General Provider Information

NPI Number	:	1578816260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW R PROCHNIAK LPC

Provider Business Mailing Address
First Line	:	1810 E BLACKLIDGE DR
Second Line	:	APT 321
City	:	TUCSON
State	:	AZ
Zip	:	85719-2772
Country	:	US
Telephone Number	:	262-880-0560
Fax Number	:

Provider Business Practice Location Address
First Line	:	3583 NE BROADWAY ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97232-1820
Country	:	US
Telephone Number	:	262-880-0560
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	10/18/2012

Similar Medicare Providers

1639110273 — DR. MAURA D. SULLIVAN PSY.D.
Practice Location Address:

3583 NE BROADWAY ST
PORTLAND, OR
97232-1820

Practice Phone: 503-432-8470
Practice Fax: 503-912-7018

1154357366 — PAUL T GIGER MD
Practice Location Address:

3583 NE BROADWAY ST
PORTLAND, OR
97232-1820

Practice Phone: 503-284-1838
Practice Fax: 503-827-0299

1396880563 — MS. LANETTE KANIKA AMBERS MSW
Practice Location Address:

3529 NE BROADWAY ST STE 201
PORTLAND, OR
97232-1820

Practice Phone: 503-317-9632
Practice Fax:

1174859458 — ATHENA PHILLIPS LCSW
Practice Location Address:

3583 NE BROADWAY ST
PORTLAND, OR
97232-1820

Practice Phone: 503-819-4181
Practice Fax: 503-827-0299

1477815033 — CARLA CANFIELD LCSW
Practice Location Address:

3583 NE BROADWAY ST
PORTLAND, OR
97232-1820

Practice Phone: 503-446-6228
Practice Fax:

1558607812 — FERTILE GROUND FAMILY CENTER, LLC
Practice Location Address:

3575 NE BROADWAY ST
PORTLAND, OR
97232-1820

Practice Phone: 503-284-6195
Practice Fax:

Directions to “ ANDREW R PROCHNIAK LPC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.