Provider Demographics
NPI:1215064175
Name:OCON, NICHOLAS PHILLIP (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:PHILLIP
Last Name:OCON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 N WILBUR AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-5257
Mailing Address - Country:US
Mailing Address - Phone:503-846-4590
Mailing Address - Fax:503-846-4560
Practice Address - Street 1:155 N 1ST AVE STE 250
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-3001
Practice Address - Country:US
Practice Address - Phone:503-846-4590
Practice Address - Fax:503-846-4560
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical