Provider Demographics
NPI:1619338670
Name:BILLINGTON, JOELLEN (CADC1)
Entity Type:Individual
Prefix:
First Name:JOELLEN
Middle Name:
Last Name:BILLINGTON
Suffix:
Gender:F
Credentials:CADC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 NW HARMON BLVD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-3060
Mailing Address - Country:US
Mailing Address - Phone:541-383-0844
Mailing Address - Fax:541-383-0840
Practice Address - Street 1:601 NW HARMON BLVD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-3060
Practice Address - Country:US
Practice Address - Phone:541-383-0844
Practice Address - Fax:541-383-0840
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)