Healthcare Provider Details

I. General information

NPI: 1073070124
Provider Name (Legal Business Name): JASON CARL BARBEE LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 NE WELLS ACRES RD
BEND OR
97701-6441
US

IV. Provider business mailing address

2230 NE WELLS ACRES RD
BEND OR
97701-6441
US

V. Phone/Fax

Practice location:
  • Phone: 208-860-3712
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC-9160
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC8875
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: