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

Individual provider Clinical Social Worker · NPI 1902280365

Kristina Ivy, LCSW is a Clinical Social Worker in Portland, Oregon. Practices as a sole proprietor. Licensed in New York and Oregon.

Licensed in
NY, OR
In the registry since
2015
Specialties on file
3
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

17727 E Burnside St
Portland, OR 97233-4803
Phone: (503) 215-9800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X (OR)
Clinical Social Worker Taxonomy 1041C0700X · Licence 084358 (NY)
Clinical Social Worker Taxonomy 1041C0700X (OR)

Record details

NPI number1902280365
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJuly 16, 2015
Last updated in NPPESFebruary 3, 2024
Certification dateFebruary 3, 2024

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