Healthcare Provider Details

I. General information

NPI: 1104202381
Provider Name (Legal Business Name): ELIZABETH REID MEYER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 NW WALL ST STE 202
BEND OR
97703-1967
US

IV. Provider business mailing address

1345 NW WALL ST STE 202
BEND OR
97703-1967
US

V. Phone/Fax

Practice location:
  • Phone: 541-241-8748
  • Fax:
Mailing address:
  • Phone: 541-241-8748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL18011
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: