Provider Demographics
NPI:1689825440
Name:HONER, CONNIE FAYE (LPC)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:FAYE
Last Name:HONER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:FAYE
Other - Last Name:HONER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:10123 SW 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-6326
Mailing Address - Country:US
Mailing Address - Phone:503-708-1729
Mailing Address - Fax:503-293-2258
Practice Address - Street 1:2929 SW MULTNOMAH BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-4072
Practice Address - Country:US
Practice Address - Phone:503-708-1429
Practice Address - Fax:503-244-7993
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional