Healthcare Provider Details

I. General information

NPI: 1740974815
Provider Name (Legal Business Name): ALITHEA T. MCHALE BA, CADCLL, QMHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 04/22/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 NE 4TH ST STE 100
BEND OR
97701-4646
US

IV. Provider business mailing address

685 SE 3RD ST
BEND OR
97702-1754
US

V. Phone/Fax

Practice location:
  • Phone: 541-617-7365
  • Fax:
Mailing address:
  • Phone: 541-668-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number24-QMHA-I-004621
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberB00002020621
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number22-12-20238
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: