Provider Demographics
NPI:1275222739
Name:WEDNESDAYS COUNSELING SERVICES
Entity Type:Organization
Organization Name:WEDNESDAYS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGGORY
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:MCVICKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-A
Authorized Official - Phone:541-546-4267
Mailing Address - Street 1:PO BOX 8234
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-8234
Mailing Address - Country:US
Mailing Address - Phone:541-546-4267
Mailing Address - Fax:
Practice Address - Street 1:235 SE YEW LN UNIT G
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1607
Practice Address - Country:US
Practice Address - Phone:541-546-4267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)