Provider Demographics
NPI:1326576687
Name:JIAN, GENELYNNE (LCSW)
Entity type:Individual
Prefix:
First Name:GENELYNNE
Middle Name:
Last Name:JIAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GENELYNNE
Other - Middle Name:
Other - Last Name:MORDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:604 S CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3298
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:604 S CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-3298
Practice Address - Country:US
Practice Address - Phone:808-651-4964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
ORL162591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIXLHR000023930910OtherHMSA