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MRS. A. NICOLE LA VERNE LPC, MAC, CADC III

Addiction Substance Use Disorder

Lake Oswego, Oregon

Provider NPI: 1083699979

Provider Information:
MRS. A. NICOLE LA VERNE LPC, MAC, CADC III
Gender: F
Sole Proprietor


Practice Location:
5200 SW MEADOWS RD., STE. 150  LAKE OSWEGO, OR 97035 US
Tel: 503-726-5216  Fax: --

Business Mailing Address:
5200 SW MEADOWS RD., STE. 150  LAKE OSWEGO, OR 97035 US
Tel: 503-726-5216  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YA0400XBehavioral Health & Social Service Providers
Counselor
Addiction (Substance Use Disorder)
OR041169U3
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
ORC1853









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