Individual provider · Type 1 NPI

Jeremy Patrick Boal, LCSW

Clinical Social Worker · Gresham, OR

NPI number 1730814005 Active

Practice location

620 NE 2nd St
Gresham, OR 97030-7514

Call (971) 274-3757 Map

Fax (503) 912-5740

Mailing address

1776 SW Madison St
Portland, OR 97205-1715

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XL15438 (OR)
Clinical Social Worker 1041C0700X2024023364 (MO)

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 1730814005

Jeremy Patrick Boal, LCSW's National Provider Identifier is 1730814005, issued on Jul 20, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Gresham, OR. The record was last updated on Jul 16, 2026.