Provider Demographics
NPI:1427047927
Name:LOVE, KATHLEEN MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:LOVE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8923 SW MARSEILLES DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-9040
Mailing Address - Country:US
Mailing Address - Phone:503-807-2704
Mailing Address - Fax:503-296-2276
Practice Address - Street 1:1675 SW MARLOW AVE STE 303
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5102
Practice Address - Country:US
Practice Address - Phone:503-807-2704
Practice Address - Fax:503-296-2276
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3805101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional