Gia J McKinzie, LCSW
Counselor, Mental Health in Portland, OR. Individual provider (NPI-1).
NPI number1669904686
StatusActive
Last updated in NPPESSep 20, 2022
Details
- NPI
- 1669904686
- Entity type
- Individual (NPI-1)
- Name
- Gia J McKinzie
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 29, 2017
- Certification date
- Sep 15, 2022
- Last updated
- Sep 20, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | OR | Yes |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 104100000X | Social Worker | LSW.0009921186 | CO | |
| 104100000X | Social Worker | L10719 | OR |
Practice location
5200 S Macadam Ave Ste 580Portland, OR 97239-3837
Phone 503-231-7854 · Fax 503-231-8153
Mailing address
902 Se Spokane Avenue, Suite 324Portland, OR 97202-3837
Phone 062-307-2604 · Fax 719-301-5267
Other practice locations
620 Ne 2nd St
Gresham, OR 97030-7514
Gresham, OR 97030-7514
Phone 971-274-3757 · Fax 503-912-5740
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