Healthcare Provider Details

I. General information

NPI: 1457975872
Provider Name (Legal Business Name): NOONDAY COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2020
Last Update Date: 06/18/2020
Certification Date: 06/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 CHARBONNEAU STE 207
BEND OR
97703-7047
US

IV. Provider business mailing address

60857 YELLOW LEAF ST
BEND OR
97702-9353
US

V. Phone/Fax

Practice location:
  • Phone: 541-551-3030
  • Fax: 541-551-3030
Mailing address:
  • Phone: 925-759-9599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier500743503
Identifier TypeMEDICAID
Identifier StateOR
Identifier Issuer

VIII. Authorized Official

Name: REBECCA JOYCE
Title or Position: OWNER
Credential:
Phone: 925-759-9599