Provider Demographics
NPI:1538362132
Name:FLANAGAN, KATE (LPC)
Entity type:Individual
Prefix:MS
First Name:KATE
Middle Name:
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 FOREST GALE DR
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-1074
Mailing Address - Country:US
Mailing Address - Phone:503-359-0736
Mailing Address - Fax:
Practice Address - Street 1:1905 MOUNTAIN VIEW LN
Practice Address - Street 2:SUITE 300
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-2380
Practice Address - Country:US
Practice Address - Phone:503-402-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCO686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional