=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124984737
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BICKFORD THERAPY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2025
-----------------------------------------------------
Last Update Date | 12/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 117 NW 8TH ST
-----------------------------------------------------
City | MCMINNVILLE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97128-5560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 971-267-9232
-----------------------------------------------------
Fax | 503-296-2097
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 E QUAIL DR
-----------------------------------------------------
City | NEWBERG
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97132-9152
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 971-267-9232
-----------------------------------------------------
Fax | 971-267-9232
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL DIRECTOR
-----------------------------------------------------
Name | TARIN LYNNE BICKFORD
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 971-267-9232
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------