Provider Demographics
NPI:1447339098
Name:BECKETT, CATHERINE (LCSW, PHD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:BECKETT
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 NE STANTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-3136
Mailing Address - Country:US
Mailing Address - Phone:503-319-8998
Mailing Address - Fax:
Practice Address - Street 1:3325 NE WASCO ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1955
Practice Address - Country:US
Practice Address - Phone:503-319-8998
Practice Address - Fax:503-546-0120
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical