Provider Demographics
NPI:1588289771
Name:MAPLETHORPE, KACIE LYNN (LPC, LMHC, MA)
Entity type:Individual
Prefix:
First Name:KACIE
Middle Name:LYNN
Last Name:MAPLETHORPE
Suffix:
Gender:
Credentials:LPC, LMHC, MA
Other - Prefix:
Other - First Name:KACIE
Other - Middle Name:LYNN
Other - Last Name:HALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, MA
Mailing Address - Street 1:2209 NE 106TH AVE APT 1923
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-8261
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6018 SE STARK ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1990
Practice Address - Country:US
Practice Address - Phone:541-517-9733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61500615101YM0800X
ORC9805101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health