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General NPI Number Information
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NPI Number | 1619774759
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Entity Type | Organization
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Legal Business Name | EBB AND FLOW MENTAL HEALTH LLC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 231 SW SCALEHOUSE LOOP STE 204
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City | BEND
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State | OR
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Zip | 97702-1277
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Country | US
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Telephone | 541-648-7980
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Fax | 541-391-5500
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Provider Business Mailing Address
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Address Line | 231 SW SCALEHOUSE LOOP STE 204
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City | BEND
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State | OR
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Zip | 97702-1277
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Country | US
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Telephone | 541-648-7980
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC, FNP-BC
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Name | ASHLEY AURORA SAPIN
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Credential | APRN-BC
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Telephone | 541-648-7980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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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