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1550 Ne Williamson Blvd Ste 110 Bend OR 97701-6091 | |
| (541) 221-6653 | |
| (541) 385-6080 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 1550 Ne Williamson Blvd Ste 110, Bend, Oregon |
| Authorized Official Name and Position | Laurie Anne Hunter (OWNER/THERAPIST) |
| Authorized Official Contact | 5412216653 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1550 Ne Williamson Blvd Ste 110 Bend OR 97701-6091 Ph: (541) 221-6653 | 1550 Ne Williamson Blvd Ste 110 Bend OR 97701-6091 Ph: (541) 221-6653 |
| NPI Number | 1821561580 |
|---|---|
| Provider Enumeration Date | 01/05/2019 |
| Last Update Date | 02/04/2025 |
| Certification Date | 02/04/2025 |
| Medicare PECOS PAC ID | 5092041061 |
|---|---|
| Medicare Enrollment ID | O20190729002716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821561580 | NPI | - | NPPES |
| 500777887 | Medicaid | OR |
| Provider Name | Gary Eugene Hunter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427450360 PECOS PAC ID: 6901132976 Enrollment ID: I20200513002562 |
| Provider Name | Laurie Anne Hunter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912322090 PECOS PAC ID: 9537495502 Enrollment ID: I20240212001254 |
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