Individual provider · Type 1 NPI

Alice Penniman Rose, LCSW

Clinical Social Worker · Portland, OR

NPI number 1629030713 Active

Practice location

5125 SW Macadam Ave, Ste 145
Portland, OR 97239

Fax (503) 231-8153

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XLCSW2352 (OR)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1629030713

Alice Penniman Rose, LCSW's National Provider Identifier is 1629030713, issued on Apr 4, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Portland, OR. The record was last updated on Jul 13, 2026.