Provider Demographics
NPI:1346654571
Name:HILLEBOE, BENJAMIN (MS)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:HILLEBOE
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 NW DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3079
Mailing Address - Country:US
Mailing Address - Phone:406-212-8464
Mailing Address - Fax:
Practice Address - Street 1:1333 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1482
Practice Address - Country:US
Practice Address - Phone:541-447-2631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health