Provider Demographics
NPI:1861157596
Name:HERMIZ, ESTHER ANNA (MT-BC, LPC)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:ANNA
Last Name:HERMIZ
Suffix:
Gender:F
Credentials:MT-BC, LPC
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:ANNA
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3540 SE 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-2736
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6400 SE LAKE RD STE 250
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2129
Practice Address - Country:US
Practice Address - Phone:541-900-4285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
C10003101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional