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General NPI Number Information
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NPI Number | 1437665478
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Entity Type | Organization
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Legal Business Name | ANDEEN COUNSELING, LLC
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Dates
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Enumeration Date | 12/27/2017
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Last Update Date | 12/27/2017
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Provider Practice Location Address
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Address Line | 60575 BILLADEAU RD
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City | BEND
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State | OR
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Zip | 97702-9338
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Country | US
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Telephone | 458-202-9366
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Fax |
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Provider Business Mailing Address
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Address Line | 1685 NW FRESNO AVE
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City | BEND
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State | OR
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Zip | 97703-3051
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ADRIENNE ANDEEN
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Credential | LCSW
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Telephone | 458-202-9366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | L7509
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License Number State | OR
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