CONNIE J KERSENBROCK, LCSW (NPI# 1710528989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710528989 |
| Entity Type | Organization |
| Organization Name | CONNIE J KERSENBROCK, LCSW |
| Practice Address |
300 Se Reed Market Rd Ste 110 Bend OR 97702-2237 |
| Mailing Address |
130 Sw Canyon Dr Apt 3 Redmond OR 97756-2054 |
| Practice Telephone | 6209666925 |
| Mailing Telephone | 6209666925 |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2019-09-30 |
| Authorized Official Name | CONNIE KERSENBROCK (OWNER) |
| Authorized Official Telephone | 6209666925 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Street Address |
300 SE REED MARKET RD STE 110 |
| City | BEND |
| State | OR |
| Zip Code | 97702-2237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942015 | Cynthia Stidd, Lcsw, LLC | Social Worker | 60831 Windsor Dr, Bend, OR 97702-9502 | 2020-11-07 |
| 1790384238 | Amy R Duryea Lcsw LLC | Social Worker | 3108 Ne Elizabeth Ct, Bend, OR 97701-7600 | 2020-10-24 |
| 1780295287 | Elizabeth Blackwood | Social Worker | 1005 Sw Disk Dr Ste 104, Bend, OR 97702-3385 | 2020-08-10 |
| 1396355889 | Xela Goodman | Social Worker | 2225 Ne Indigo Ln, Bend, OR 97701-6731 | 2020-08-09 |
| 1457975872 | Noonday Counseling and Wellness | Social Worker | 750 Charbonneau Ste 207, Bend, OR 97703-7047 | 2020-06-01 |
| 1083254676 | Nourish Lactation | Social Worker | 19334 Mohawk Rd, Bend, OR 97702-8908 | 2020-01-10 |
| 1982245734 | Hannah Wadsworth | Social Worker | 1900 Ne Division St Ste 108, Bend, OR 97701-3526 | 2019-10-02 |
| 1265085625 | Rachel L Frank LLC | Social Worker | 20766 Ne Sierra Dr, Bend, OR 97701-7174 | 2019-07-24 |
| 1366008856 | Sarah Elizabeth Peterson | Social Worker | 19795 Village Office Ct, Bend, OR 97702-1922 | 2019-05-10 |
| 1750853453 | Adam Klaybor | Social Worker | 19820 Village Office Ct Ste 301, Bend, OR 97702-2950 | 2018-12-19 |
| Find all providers in BEND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.