Individual provider · Type 1 NPI

Lucy Rose Peterson, CADC II, QMHA-R

Addiction (Substance Use Disorder) Counselor · Portland, OR

NPI number 1053681452 Active

Practice location

17645 NW Saint Helens Rd
Portland, OR 97231-1729

Call (503) 621-1069 Map

Fax (503) 621-0200

Mailing address

211 SE Caruthers St
Portland, OR 97214-4502

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X24-QMHA-R-6074 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X00-03-32 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1053681452

Lucy Rose Peterson, CADC II, QMHA-R's National Provider Identifier is 1053681452, issued on Jan 3, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Portland, OR. The record was last updated on Aug 24, 2026.