Provider Demographics
NPI:1730323874
Name:FERREIRA, CAROLYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:
Last Name:FERREIRA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SE REED MARKET RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2237
Mailing Address - Country:US
Mailing Address - Phone:541-213-8700
Mailing Address - Fax:541-631-5106
Practice Address - Street 1:300 SE REED MARKET RD
Practice Address - Street 2:SUITE 260
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2237
Practice Address - Country:US
Practice Address - Phone:541-213-8700
Practice Address - Fax:541-631-5106
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2550103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical