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General NPI Number Information
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NPI Number | 1568396992
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Entity Type | Organization
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Legal Business Name | EQUINOX INTEGRATIVE COUNSELING LLC
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 497 SW CENTURY DR STE 4
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City | BEND
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State | OR
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Zip | 97702-1167
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Country | US
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Telephone | 503-318-2335
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Fax |
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Provider Business Mailing Address
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Address Line | 19575 FISHER LAKE LN
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City | BEND
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State | OR
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Zip | 97702-9181
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Country | US
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Telephone | 503-318-2335
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | DAVID M MACOMBER
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Credential | LPC
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Telephone | 503-318-2335
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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 |
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License Number State |
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