Provider Demographics
NPI:1588776827
Name:HESS, MARC BRIAN (LCSW)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:BRIAN
Last Name:HESS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 SE ANKENY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1622
Mailing Address - Country:US
Mailing Address - Phone:503-313-4077
Mailing Address - Fax:503-233-4353
Practice Address - Street 1:2006 SE ANKENY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1622
Practice Address - Country:US
Practice Address - Phone:503-313-4077
Practice Address - Fax:503-233-4353
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL26401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical