| Broken Top Counseling, Llc | |
|
760 Nw Harriman St Ste 100 Bend OR 97703-2789 | |
| (541) 280-5210 | |
| Not Available |
| Full Name | Broken Top Counseling, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 760 Nw Harriman St Ste 100, Bend, Oregon |
| Authorized Official Name and Position | Timothy Moore (OWNER) |
| Authorized Official Contact | 5412805210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broken Top Counseling, Llc 760 Nw Harriman St Ste 100 Bend OR 97703-2789 Ph: (541) 280-5210 | Broken Top Counseling, Llc 760 Nw Harriman St Ste 100 Bend OR 97703-2789 Ph: (541) 280-5210 |
| NPI Number | 1679217673 |
|---|---|
| Provider Enumeration Date | 04/25/2022 |
| Last Update Date | 04/25/2022 |
| Certification Date | 04/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679217673 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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