Provider Demographics
NPI:1730952219
Name:REASOR, SETH C (LMSW, CSWA)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:C
Last Name:REASOR
Suffix:
Gender:M
Credentials:LMSW, CSWA
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:ESCARCEGA
Other - Last Name:LUJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, LCDC-I
Mailing Address - Street 1:5908 SW KARLA CT
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-1182
Mailing Address - Country:US
Mailing Address - Phone:214-293-5978
Mailing Address - Fax:
Practice Address - Street 1:5908 SW KARLA CT
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-1182
Practice Address - Country:US
Practice Address - Phone:214-293-5978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA125921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical