MIRROR POND COUNSELING LLC (NPI# 1811531262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811531262 |
| Entity Type | Organization |
| Organization Name | MIRROR POND COUNSELING LLC |
| Practice Address |
754 Nw Broadway St Ste 207 Bend OR 97703-2776 |
| Practice Telephone | 5416687558 |
| Mailing Telephone | 5416687558 |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |
| Authorized Official Name | KIMBERLY DREW (OWNER) |
| Authorized Official Telephone | 5416687558 |
| Authorized Official Credential | MA, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
Behavioral Health & Social Service Providers | ||
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 101YP1600X |
Counselor Specialization: Pastoral |
Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Mirror Pond Counseling | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MIRROR POND COUNSELING LLC | 754 Nw Broadway Street Ste 207, Bend, OR 97703 |
| Street Address |
754 NW BROADWAY ST STE 207 |
| City | BEND |
| State | OR |
| Zip Code | 97703-2776 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285250704 | Elizabeth Jane Lindt | Counselor | 63311 Jamison Street, Bend, OR 97703 | 2020-06-20 |
| 1790318145 | Leah Alice Williamson | Counselor | 118 Nw Thurston Ave, Bend, OR 97703 | 2020-02-13 |
| 1831658301 | Pretty Moments Lingerie, LLC | Durable Medical Equipment & Medical Supplies | 63455 N Hwy 97 Suite 44, Bend, OR 97703 | 2019-03-14 |
| 1821561150 | Kevin Hallmeyer | Chiropractor | 750 Nw Charbonneau St., Suite 101, Bend, OR 97703 | 2019-01-09 |
| 1346743267 | Jesse Maggie Mae Abraham | Massage Therapist | 39 Nw Lousiana Ave, Bend, OR 97703 | 2018-03-16 |
| 1891202396 | Jerod Paul Michael | Speech-Language Pathologist | 2736 Nw Crossing Dr, Ste. 120, Bend, OR 97703 | 2018-01-05 |
| 1952823023 | Dan Packman | Massage Therapist | 2955 N. Hwy 97, Ste 105, Riverside Wellness, Voila Massage, Bend, OR 97703 | 2017-07-11 |
| 1023460102 | Brennon Patrick Moore | Counselor | 835 Nw Bond St Ste 100, Bend, OR 97703 | 2016-07-12 |
| 1093160269 | Eric Hinds | Optometrist | 63455 N Highway 97 Ste 75, Bend, OR 97703 | 2016-04-25 |
| 1417316191 | Ronald Guiley Od, Mph, PC | Clinic/Center | 63455 N Hwy 97, Ste 75, Bend, OR 97703 | 2016-02-23 |
| Find all providers in zip 97703 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649341827 | Jeffrey James Gray | Psychologist | 2254 Nw West Hills Ave, Bend, OR 97701-1047 | 2006-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932722345 | Izmirian Counseling, PC | Psychologist | 1450 Se Holgate Blvd, Portland, OR 97202-4717 | 2020-05-19 |
| 1538728472 | Little Star Psychological Services, LLC | Psychologist | 1127 Lincoln St, Eugene, OR 97401-3695 | 2019-06-12 |
| 1013573286 | Erin Fuller Crozier | Psychologist | 408 Sw Monroe Ave Ste M252, Corvallis, OR 97333-7210 | 2019-05-14 |
| 1225506702 | Michele Ribeiro | Psychologist | 511 Nw 11th St, Corvallis, OR 97330-6010 | 2018-11-02 |
| 1669959078 | Pamela Michelle Taite | Psychologist | 1785 Ne Sandy Blvd Ste 270, Portland, OR 97232-2791 | 2018-07-27 |
| 1861850737 | Traci Rieckmann | Psychologist | 2925 Ne 53rd Ave, Portland, OR 97213-2437 | 2016-02-05 |
| 1710370101 | Asha Stephen | Psychologist | 1590 E.13th Ave, Eugene, OR 97403 | 2015-03-10 |
| 1801289343 | Alisia Caban | Psychologist | 1590 E 13th Ave., University Counseling & Testing Center, Eugene, OR 97403-1280 | 2015-03-09 |
| 1336532860 | Heather Brooks Morse | Psychologist | 2228 West 25th Place, Eugene, OR 97405 | 2015-03-09 |
| 1073905758 | Brent Horner | Psychologist | 132 E Broadway Ste 301, Eugene, OR 97401-3154 | 2015-03-04 |
| Find all providers with the same taxonomy | ||||
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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.