Provider Demographics
NPI:1649688474
Name:STINEA, DANIEL (LPC, CADC III)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:STINEA
Suffix:
Gender:M
Credentials:LPC, CADC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7111 SE 63RD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-7413
Mailing Address - Country:US
Mailing Address - Phone:503-209-2392
Mailing Address - Fax:
Practice Address - Street 1:4410 SE WOODSTOCK BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97206-6206
Practice Address - Country:US
Practice Address - Phone:503-209-2392
Practice Address - Fax:503-244-7424
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4176101YM0800X
OR12-09-47101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)