Provider Demographics
NPI:1508452012
Name:BIRGIT SHOW LICENSED PROFESSIONAL COUNSELOR
Entity Type:Organization
Organization Name:BIRGIT SHOW LICENSED PROFESSIONAL COUNSELOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BIRGIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOW
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-797-3794
Mailing Address - Street 1:17078 FONTANA RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97707-2041
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:925 NW WALL ST STE 203
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2052
Practice Address - Country:US
Practice Address - Phone:541-797-3794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty