Provider Demographics
NPI:1720603897
Name:EQUINIMITY, LLC
Entity Type:Organization
Organization Name:EQUINIMITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROMINA
Authorized Official - Middle Name:FRIDA
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT, CEIP-MH
Authorized Official - Phone:541-797-4516
Mailing Address - Street 1:60330 RIMFIRE RD
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-9236
Mailing Address - Country:US
Mailing Address - Phone:541-797-4516
Mailing Address - Fax:
Practice Address - Street 1:60330 RIMFIRE RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-9236
Practice Address - Country:US
Practice Address - Phone:541-797-4516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-14
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty