Provider Demographics
NPI:1386070423
Name:GROENER, DIANA (LPC)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:GROENER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 SW EASTRIDGE ST STE 235
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5063
Mailing Address - Country:US
Mailing Address - Phone:503-292-1885
Mailing Address - Fax:
Practice Address - Street 1:10200 SW EASTRIDGE ST STE 235
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5063
Practice Address - Country:US
Practice Address - Phone:503-292-1885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3156101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor