Healthcare Provider Details

I. General information

NPI: 1255976379
Provider Name (Legal Business Name): REBECCA N BROWN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA N MCCOWAN LPC

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19855 4TH ST STE 106
BEND OR
97703-7814
US

IV. Provider business mailing address

PO BOX 6513
BEND OR
97708-6513
US

V. Phone/Fax

Practice location:
  • Phone: 541-329-0439
  • Fax: 541-229-1259
Mailing address:
  • Phone: 541-329-0439
  • Fax: 541-229-1259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC3003
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: