Organization · Type 2 NPI

Lotus Teegarden, LLC

Clinical Social Worker · Portland, OR

NPI number 1679453104 Active

Practice location

1940 NE Broadway St
Portland, OR 97232-1502

Fax (503) 388-3397

Specialties and licenses

Taxonomy	Code	License
Addiction (Substance Use Disorder) Counselor	101YA0400X	None listed
Mental Health Counselor	101YM0800X	None listed
Clinical Social Worker Primary	1041C0700X	None listed

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 1679453104

Lotus Teegarden, LLC's National Provider Identifier is 1679453104, issued on Sep 4, 2025. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Portland, OR. The record was last updated on Sep 4, 2025.