Healthcare Provider Details

I. General information

NPI: 1366847535
Provider Name (Legal Business Name): REBECCA WINTERS MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2014
Last Update Date: 09/11/2025
Certification Date: 06/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 W ANTLER AVE
REDMOND OR
97756-1852
US

IV. Provider business mailing address

128 W ANTLER AVE
REDMOND OR
97756-1852
US

V. Phone/Fax

Practice location:
  • Phone: 541-255-1192
  • Fax: 541-314-9633
Mailing address:
  • Phone: 541-255-1192
  • Fax: 541-314-9633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC5089
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: