Provider Demographics
NPI:1619536349
Name:MID-OREGON COUNSELING, LLC
Entity type:Organization
Organization Name:MID-OREGON COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TIMMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:541-410-5021
Mailing Address - Street 1:21032 BAYOU DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2438
Mailing Address - Country:US
Mailing Address - Phone:541-410-5021
Mailing Address - Fax:
Practice Address - Street 1:220 NW OREGON AVE STE 202
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2745
Practice Address - Country:US
Practice Address - Phone:541-410-5021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty