Provider Demographics
NPI:1679779839
Name:SUAREZ, LUCRECIA V (LCSW)
Entity type:Individual
Prefix:
First Name:LUCRECIA
Middle Name:V
Last Name:SUAREZ
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 SW KING AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1110
Mailing Address - Country:US
Mailing Address - Phone:503-410-4475
Mailing Address - Fax:877-744-1853
Practice Address - Street 1:1012 SW KING AVE STE 303
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1110
Practice Address - Country:US
Practice Address - Phone:503-410-4475
Practice Address - Fax:877-744-1853
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical