Kasey M Lix | Portland, OR • PECOS Search

Kasey M Lix

Counselor

Behavioral Health & Social Service Providers

948 NE 102nd Ave Ste 101, Portland, OR 97220-4064

(503) 257-0381 (503) 267-1761

PECOS Enrollment

Based on the most recent information from CMS, provider Kasey M Lix does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1710540869
Provider Type
Individual
Full Name
Lix, Kasey M
Credential
LPC INTERN R5121

Gender
Female
Sole Proprietor
No
Enumeration Date
4/15/2019
Last Updated
4/15/2019

Contact Information

Practice Location

948 NE 102nd Ave Ste 101, Portland, OR 97220-4064

Unlisted Fax

Mailing Location

10305 SE Bell Ave, Milwaukie, OR 97222-2230

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License R5121 Oregon