Provider Demographics
NPI:1194886929
Name:NAIMO, TERESA A (LPC NCC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:NAIMO
Suffix:
Gender:F
Credentials:LPC NCC
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:SCHULZE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC NCC
Mailing Address - Street 1:PO BOX 82819
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97282
Mailing Address - Country:US
Mailing Address - Phone:503-233-5405
Mailing Address - Fax:503-233-2696
Practice Address - Street 1:19500 SE STARK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-5757
Practice Address - Country:US
Practice Address - Phone:503-253-4600
Practice Address - Fax:503-253-4609
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLPCC1688101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR164936Medicaid
OR164936Medicaid