Provider Demographics
NPI:1215378047
Name:HOPKINS, ANDREA (LCSW, LPC, MAC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:LCSW, LPC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 SE LEXINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6150
Mailing Address - Country:US
Mailing Address - Phone:541-609-0712
Mailing Address - Fax:
Practice Address - Street 1:15300 SE MINUTEMAN WAY
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9372
Practice Address - Country:US
Practice Address - Phone:503-683-4903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4084101YP2500X
ORL60971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional