Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Lake Cornog

Individual provider Mental Health Counselor · NPI 1962289470

Kenneth Lake Cornog is a Mental Health Counselor in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2023.

Licensed in
OR
In the registry since
2023

Practice location Address checks out

3231 SE 50th Ave
Portland, OR 97206-2248
Phone: (503) 238-5203
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence R9487 (OR)

Record details

NPI number1962289470
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 11, 2023
Last updated in NPPESOctober 6, 2025
Certification dateOctober 6, 2025
Mailing address716 Se 29th Ave, Portland, OR 97214-3028

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