Healthcare Provider Details
I. General information
NPI: 1114603289
Provider Name (Legal Business Name): CHANGING WINDS COUNSELING AND CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/23/2023
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
920 SW FRAZER AVE STE 212
PENDLETON OR
97801-2802
US
IV. Provider business mailing address
920 SW FRAZER AVE STE 211
PENDLETON OR
97801-2802
US
V. Phone/Fax
- Phone: 541-429-4940
- Fax: 541-429-4941
- Phone: 541-429-4940
- Fax: 541-429-4941
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
BYRON
RINEHART
Title or Position: OWNER
Credential: BS, CADC II, QMHA-R
Phone: 541-429-4940