Provider Demographics
NPI:1275153983
Name:RIVERBEND FAMILY COUNSELING
Entity Type:Organization
Organization Name:RIVERBEND FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:714-833-2653
Mailing Address - Street 1:497 SW CENTURY DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1167
Mailing Address - Country:US
Mailing Address - Phone:541-896-1098
Mailing Address - Fax:
Practice Address - Street 1:497 SW CENTURY DR STE 102
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1167
Practice Address - Country:US
Practice Address - Phone:541-896-1098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty