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NPI 1578438610

NPI 1578438610 : HALEY BRINK THERAPY LLC : BEND, OR

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General NPI Number Information
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    NPI Number           |    1578438610
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    Entity Type          |    Organization 
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    Legal Business Name  |    HALEY BRINK THERAPY LLC 
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Dates
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    Enumeration Date     |    10/08/2025
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    Last Update Date     |    11/25/2025
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Provider Practice Location Address
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    Address Line         |    2855 NW CROSSING DR STE 212 
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    City                 |    BEND
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    State                |    OR
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    Zip                  |    97703-7049
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    Country              |    US
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    Telephone            |    541-223-9580
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2855 NW CROSSING DR STE 212 
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    City                 |    BEND
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    State                |    OR
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    Zip                  |    97703-7049
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    Country              |    US
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    Telephone            |    541-223-9580
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     HALEY  BRINK 
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    Credential           |    LMFT
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    Telephone            |    541-223-9580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    
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    License Number State |    
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