Healthcare Provider Details

I. General information

NPI: 1780274324
Provider Name (Legal Business Name): JEANNE SAXTON MERRITT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2021
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 SW MILL VIEW WAY STE 250
BEND OR
97702-1562
US

IV. Provider business mailing address

PO BOX 1487
BEND OR
97709-1487
US

V. Phone/Fax

Practice location:
  • Phone: 541-782-8377
  • Fax: 541-833-6416
Mailing address:
  • Phone: 541-782-8377
  • Fax: 541-833-6416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL16517
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: