Provider Demographics
NPI:1376815167
Name:O'HANA, AMY (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:O'HANA
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LPC
Mailing Address - Street 1:61141 S HWY 97
Mailing Address - Street 2:PMB 162
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2523
Mailing Address - Country:US
Mailing Address - Phone:541-515-5213
Mailing Address - Fax:
Practice Address - Street 1:61690 PETTIGREW RD
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2422
Practice Address - Country:US
Practice Address - Phone:541-515-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3682101YP2500X
ORLPC-C3682101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional