Healthcare Provider Details

I. General information

NPI: 1295005080
Provider Name (Legal Business Name): MICHAEL SEAN DOWNES LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 05/30/2025
Certification Date: 05/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 SW CENTURY DR STE 103
BEND OR
97702-1112
US

IV. Provider business mailing address

377 SW CENTURY DR STE 103
BEND OR
97702-1112
US

V. Phone/Fax

Practice location:
  • Phone: 541-699-1466
  • Fax: 541-229-0616
Mailing address:
  • Phone: 541-699-1466
  • Fax: 541-229-0616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI-04782
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberI-04782
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-04782
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7095
License Number StateOR
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL7095
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: