Provider Demographics
NPI:1306649058
Name:WOOLDRIDGE, WILLIAM (LCSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:WOOLDRIDGE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:BILL
Other - Middle Name:
Other - Last Name:WOOLDRIDGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3535 NE 43RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-1013
Mailing Address - Country:US
Mailing Address - Phone:503-267-9027
Mailing Address - Fax:
Practice Address - Street 1:3535 NE 43RD AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1013
Practice Address - Country:US
Practice Address - Phone:503-267-9027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL3789101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health