Provider Demographics
NPI:1912547696
Name:THERAPY TALKS, LLC
Entity Type:Organization
Organization Name:THERAPY TALKS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DICENZO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-300-5224
Mailing Address - Street 1:946 SW VETERANS WAY STE 102
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-2745
Mailing Address - Country:US
Mailing Address - Phone:541-896-1940
Mailing Address - Fax:
Practice Address - Street 1:190 NW 4TH ST
Practice Address - Street 2:
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754-1820
Practice Address - Country:US
Practice Address - Phone:541-896-1940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500684076Medicaid